手术中超说明书用药现状分析  

Analysis of current situation of off-label drug use in operation

作　　者：任春玲 王丽平 潘茗[2] 池里群 曲素欣 REN Chun-ling;WANG Li-ping;PAN Ming;CHI Li-qun;QU Su-xin(Department of Pharmacy,Qingdao Women and Children's Hospital,Shandong Qingdao 266000,China;Department of Pharmacy,Qingdao Municipal Hospital,Shandong Qingdao 266000,China;Department of Pharmacy,Beijing Haidian Maternal and Child Health Hospital,Beijing 100089,China)

机构地区：[1]青岛妇女儿童医院药学部,山东青岛266000 [2]青岛市市立医院药学部,山东青岛266000 [3]北京市海淀区妇幼保健院药学部,北京100089

出　　处：《临床药物治疗杂志》2021年第9期60-64,共5页Clinical Medication Journal

摘　　要：目的开展以临床问题为导向的超说明书用药管理,主动筛查手术中超说明书用药,保证术中用药安全。方法回顾性分析2019年1月1日至12月31日期间青岛妇女儿童医院22365台手术医嘱,除溶媒以外的87种药品相关共计200548条医嘱,对超说明书用药情况分类统计分析。通过检索Up To Date循证医学数据库、中国知网及PubMed等数据库对临床普遍使用的重点超说明书用药进行循证学论证。结果存在超说明书现象的药品共计58种,占66.67%;共有59896条超说明书医嘱,占总医嘱数的29.86%,其中超适宜人群40.51%、超适应证19.90%、超给药途径19.29%、超给药剂量14.14%及超禁忌证6.16%。除地塞米松超说明书用药预防术后恶心呕吐循证学证据充足外,其他均需进一步论证。结论术中超说明书用药主要为超适宜人群。部分无循证学依据却频繁使用的药品需加强监管及不良反应监测,以保证给药安全。Objective To carry out the management of off-label drug use oriented by clinical problems and active surveil⁃lance of off-label drug use during operation,and ensure the medication safety in operation.Methods We retrospectively ana⁃lyzed 22365 operations from January 1st to December 31st,2019 in Qingdao Women and Children's Hospital.There were a total of 87 kinds of drugs other than solvent,and 200548 prescriptions.Classified statistical analysis methods were adopted in the off-label drug use.The key off-label drug use in practice was demonstrated based on evidences,which were retrieved from database of Up To Date evidence-based medicine(EBM),CNKI and PubMed.Results The results showed that there were 58 kinds of off-label drugs,which accounted for 66.67%of the total number of intraoperative drugs.There were 59896 off-label prescriptions,accounting for 29.86%of the total number of prescriptions,with 40.51%of inappropriate population,19.90%of inappropriate indication,19.29%of inappropriate administration route,14.14%of inappropriate administration dose and 6.16%of contraindications.Only Dexamethasone used for preventing postoperative nausea and vomiting had suffi⁃cient evidences.Other off-label drug uses were failed to find evidences support.Conclusion The majority of intraoperative off-label drug use was applied by inappropriate population.In order to guarantee medication safety,some frequently used drugs without evidence support need to be supervised and monitored for its adverse reactions.

关 键 词：术中用药 超说明书用药 不良反应 

分 类 号：R969.3[医药卫生—药理学]