重症监护室患者中治疗药物之间Y型管配伍禁忌的研究  

Study on Compatibility for Intravenous Y-Site Drug Administration in a Intensive Care Unit

作　　者：邓健浩[1] 吴灿明[2] 邓兴[2] 谢丽珊[1] 邱树胜[1] 林素珍[1] DENG Jian-hao;WU Chan-ming;DENG Xing;XIE Li-shan;QIU Shu-sheng;LIN Shu-zhen(Pharmacy Department Longyan Second Hospital,Longyan 364002,China;Intensive Care Unit of Longyan Second Hospital,Longyan 364002,China)

机构地区：[1]龙岩市第二医院药学部,福建龙岩364002 [2]龙岩市第二医院重症医学科,福建龙岩364002

出　　处：《海峡药学》2022年第1期147-151,共5页Strait Pharmaceutical Journal

基　　金：福建省卫生健康科技计划项目(项目编号:2017-2-88)。

摘　　要：目的本研究旨在调查本院重症监护室的患者中治疗药物之间的Y型管物理和化学配伍禁忌的发生率,便于临床合理用药。方法从龙岩市第二医院2016年1至2018年12月的954份重症医学科病历中,抽取符合入组标准的病历314份。使用MICROMEDEX,pubmed、Lexicomp、中国知网、维普、万方数据库系统电子文献检索,评估药物组合间的物理相容性或化学稳定性。结果314份的病历中共检出107种药物,可检索到Y-型管配伍禁忌的药物54种,共有2862组不同的两两药物组合,324组药物与药物之间可以相互配伍,占比11.32%;41组药物与药物之间配伍需谨慎,占比1.43%;80组药物与药物之间存在配伍禁忌,占比2.80%;最常见的Y型管配伍禁忌依次发生在咪达唑仑与质子泵抑制剂、咪达唑仑与糖皮质激素、泮托拉唑与喹诺酮类药物。药物与药物同时使用Y型的过程中存在配伍禁忌的病历共122份,占38.85%;须谨慎配伍的病历有24份,占7.64%;无配伍禁忌或未测出配伍禁忌的病历共36份,占11.46%。其中122份病历涉及配伍禁忌中,最常见的为咪达唑仑、泮托拉唑钠和呋塞米。结论重症监护室病人用药的Y型管配伍禁忌的发生率较高,且部分药物尚缺乏配伍的相关研究数据。重症监护室的药师可以通过识别Y型管配伍相容性从而发挥应有的作用。OBJECTIVE This study aims to investigate the incidence of incompatibility of Y-site physical and chemical compatibility among patients in the intensive care unit of our hospital.METHODS From January 2016 to December 2018,we chose 314 cases who meet the inclusion criteria from the 954 inpatients of Intensive Care Medicine Department.Using MICROMEDEX,pubmed,Lexicomp,CNKI,VIP,Wanfang database to evaluate the physical compatibility or chemical stability.RESULTS In the retrospective analysis of 314 patients,107 drugs were detected,54 drugs can be retrieved in databases.There are 2862 brands of drug pairs.11.32% of the drug pairs were compatible,1.43% of the drug pairs were variable compatibility,2.80% of the drug pairs were incompatible;The most commonly found drug incompatibilities were between midazolam and PPIs,between glucocorticoid and midazolam,between pantoprazole and quinolones.122 patients were incompatible which accounting for 38.85%;24 patients were variable compatibility which accounting for 7.64%;36 patients were compatible which accounting for 11.46%.The drugs most commonly involved in incompatibilities were midazolam,pantoprazole,and furosemide.CONCLUSION The incidence of contraindications of Y-site compatibility for patients in intensive care unit is relatively high,and there is still a lack of relevant research data on compatibility of some drugs.Pharmacists in the intensive care department can play roles by identifying the compatibility of Y-site compatibility.

关 键 词：重症监护室 物理相容性 化学稳定性 Y型管配伍禁忌 

分 类 号：R969.4[医药卫生—药理学]