基于《质子泵抑制剂临床应用指导原则(2020年版)》评价质子泵抑制剂的合理使用情况  

Evaluation on the rational use of proton pump inhibitors based on the Guidelines for Clinical Use of Proton Pump Inhibitors(2020 edition)

作　　者：李春杏 王月[1] 任昭[1] 满春霞 谢清[1] 高玲燕[1] 顾斯萌 梁硕 刘桦[1] LI Chun-xing;WANG Yue;REN Zhao;MAN Chun-xia;XIE Qing;GAO Ling-yan;GU Si-meng;LIANG Shuo;LIU Hua(Department of Pharmacy,Aerospace Center Hospital,Beijing100049,China)

机构地区：[1]航天中心医院药剂科,北京100049

出　　处：《临床药物治疗杂志》2022年第12期71-75,共5页Clinical Medication Journal

基　　金：航天中心医院科研基金资助项目(YN202113、YN202211)。

摘　　要：目的评价某三级医疗机构质子泵抑制剂(PPIs)的临床应用现状,以便促进临床规范使用PPIs。方法基于《质子泵抑制剂临床应用指导原则(2020年版)》(《指导原则》),从适应证、用法用量、相互作用及特殊人群用药等4个方面评价该院2021年度20个住院病区随机抽样的PPIs临床应用数据。结果共收集2131份病历,患者PPIs的应用情况与《指导原则》中推荐意见比较,在适应证方面,948例治疗用药患者中,有51例(5.38%)急性胰腺炎患者不能明确判断;1183例预防用药患者中,有432例(36.52%)明确不符合,645例(54.52%)符合,106例(8.96%)不能明确判断。在用法用量方面,1639例患者中,1058例(64.55%)符合,581例(35.45%)不符合,165例患者给药疗程不符合。在相互作用方面,87例患者氯吡格雷与艾司奥美拉唑或奥美拉唑同时使用。在特殊人群用药方面,33例肝肾功能不全患者使用PPIs超过限定日剂量。结论该院PPIs临床应用情况与《指导原则》中推荐意见有一定差距,应采取措施进一步规范PPIs的临床合理用药。Objective To evaluate the clinical utilization status of proton pump inhibitors(PPIs)in a tertiary medical institution,so as to promote the standardized use of PPIs in clinical practice.Methods The clinical data of PPIs randomly sampled from 20 inpatient departments of this medical institution in 2021.Based on the Guidelines for Clinical Use of Proton Pump Inhibitors(2020 edition)("Guidelines"),the application was evaluated from four aspects,including indication,usage and dosage,interaction,and medication for special population.Results The application of PPIs in 2131 patients was compared with the recommendations of the"Guidelines".Indications:among 948 patients with therapeutic indication,51 patients(5.38%)with acute pancreatitis could not be clearly judged.Among 1183 patients with prophylactic use,432 patients(36.52%)did not comply with the"Guidelines",645 patients(54.52%)did,and 106 patients(8.96%)could not be clearly judged.Usage and dosage:among 1639 patients,581 cases(35.45%)did not comply with the"Guidelines",1058 cases(64.55%)did.165 patients did not meet the requirement of treatment duration.Interaction:87 patients received clopidogrel combined with esomeprazole or omeprazole.Use of PPIs in special population:33 patients with hepatic and renal insufficiency used PPIs exceeding the prescribed daily dose.Conclusion There is a certain gap between the clinical application of PPIs in this medical institution and the recommendation of the"Guidelines".Measures should be taken to further standardize the rational clinical use of PPIs.

关 键 词：质子泵抑制剂 指导原则 医疗机构 合理使用 

分 类 号：R975.2[医药卫生—药品]