质子泵抑制剂预防外科手术患者应激性溃疡的管理效果分析  

Effect analysis of proton pump inhibitors in preventing stress ulcer in perioperative patients

作　　者：韩芙蓉[1] 张弨 李彤[2] 宋智慧[1] 徐姗姗[1] 王昕[1] HAN Fu-rong;ZHANG Chao;LI Tong;SONG Zhi-hui;XU Shan-shan;WANG Xin(Department of Pharmacy,Beijing Tongren Hospital,Capital Medical University Beijing 100730,China;Intensive Care Unit,Beijing Tongren Hospital,Capital Medical University Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院药学部,北京100730 [2]首都医科大学附属北京同仁医院重症医学科,北京100730

出　　处：《临床药物治疗杂志》2023年第1期86-89,共4页Clinical Medication Journal

摘　　要：目的分析首都医科大学附属北京同仁医院外科手术住院患者应用质子泵抑制剂预防应激性溃疡的管理效果。方法针对外科手术住院患者应用质子泵抑制剂预防应激性溃疡的状况进行规范化管理,分析管理前后质子泵抑制剂作为预防用药的合理性及药品费用的变化情况。结果通过在北京同仁医院实施质子泵抑制剂预防应激性溃疡的规范化管理措施,制定《北京同仁医院手术预防用质子泵抑制剂临床应用与管理规范》,外科手术住院患者应用质子泵抑制剂预防用药的合理率由管理前的44.0%升至管理后的68.2%(χ^(2)=19.803,P<0.05),适应证不适宜的比例由42.4%降至20.9%(χ^(2)=17.362,P<0.05),药物选择不适宜的比例由9.4%降至0.7%(χ^(2)=12.063,P<0.05),用法用量不适宜的比例由25.1%降至13.5%(χ^(2)=7.018,P<0.05),用药疗程不适宜的比例由15.7%降至4.7%(χ^(2)=10.334,P<0.05),患者出院后继续应用质子泵抑制剂预防用药的比例由12.6%降至4.7%(χ^(2)=6.162,P<0.05),应用质子泵抑制剂预防用药的药品平均费用支出由388.9元降至217.0元(Z=2.706,P<0.05)。结论对外科手术住院患者应用质子泵抑制剂预防应激性溃疡进行规范化管理可以促进外科手术住院患者应激性溃疡预防的临床合理使用。Objective To analysis the standardized management and effectiveness of proton pump inhibitors on stress ul?cer in perioperative inpatients of Beijing Tongren Hospital,Capital Medical University.Methods The management of perioper?ative patients using proton pump inhibitors to prevent stress ulcer was standardized,and the rationality use of proton pump in?hibitors for preventing stress ulcer before and after management as well as the change of drug cost expenditure were analyzed.Results Through the implementation of standardized management measures of proton pump inhibitors in the prevention of stress ulcer in Beijing Tongren Hospital,the clinical application and management standard of perioperative prophylactic use of proton pump inhibitors in Beijing Tongren Hospital was formulated.The rational rate of perioperative application of proton pump inhibitors to prevent stress ulcer increased from 44.0%before mamagement to 68.2%after management(χ^(2)=19.803,P<0.05),the proportion of inappropriate indications decreased from 42.4%before mamagement to 20.9%after management(χ^(2)=17.362,P<0.05),and the proportion of inappropriate drug selection decreased from 9.4%before mamagement to 0.7%after management(χ^(2)=12.063,P<0.05).The proportion of inappropriate usage and dosage decreased from 25.1%before management to 13.5%after management(χ^(2)=7.018,P<0.05).The proportion of inappropriate medication course decreased from 15.7%before management to 4.7%after management(χ^(2)=10.334,P<0.05).The proportion of perioperative patients who continued to prevent stress ulcer after discharge decreased from 12.6%before management to 4.7%after management(χ^(2)=6.162,P<0.05).The average cost of proton pump inhibitors for preventing stress ulcer in perioperative patients decreased from 388.9 yuan before standardized management to 217.0 yuan after standardized management(Z=2.706,P<0.05).Conclusion The standardized management of proton pump inhibitors to prevent stress ulcer in perioperative patients can pro?mote the rationalization of

关 键 词：质子泵抑制剂 应激性溃疡 手术患者 

分 类 号：R975.6[医药卫生—药品] R573.1[医药卫生—药学]