耳鼻咽喉头颈外科手术患者质子泵抑制剂预防用药合理性及影响因素  

Appropriateness and influencing factors of preventive use of proton pump inhibitors in patients undergoing otolaryngology head and neck surgery

作　　者：韩芙蓉[1] 李彤[2] 宋智慧[1] 徐姗姗[1] 王昕[1] 张弨 HAN Fu-rong;LI Tong;SONG Zhi-hui;XU Shan-shan;WANG Xin;ZHANG Chao(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8期86-89,共4页Clinical Medication Journal

基　　金：北京药学会临床药学研究项目(2019-01-05)。

摘　　要：目的 分析首都医科大学附属北京同仁医院耳鼻咽喉头颈外科手术患者应用质子泵抑制剂预防应激性溃疡的用药合理性及其相关影响因素。方法 参照北京市医院管理中心《围手术期预防用质子泵抑制剂专项医嘱点评规则》对耳鼻咽喉头颈外科手术患者应用质子泵抑制剂预防应激性溃疡的用药合理性进行评价,采用logistic回归分析影响用药合理性的因素。结果 共纳入327例住院患者。质子泵抑制剂预防应激性溃疡的合理率为52.3%,应用指征、用法用量、用药疗程合理的占比分别为60.9%、77.7%、85.0%。logistic回归分析表明,质子泵抑制剂预防应激性溃疡的不合理用药与患有高血压合并症呈正相关(OR=2.528,95%CI:1.219~5.243),与手术时间>3 h呈负相关(OR=0.024,95%CI:0.012~0.046)。结论 该院耳鼻咽喉头颈外科存在手术患者使用质子泵抑制剂预防应激性溃疡不合理的问题,需要进一步制订规范化管理措施以促进耳鼻咽喉头颈外科手术患者应激性溃疡预防的临床合理使用。Objective To analyze the rationality of proton pump inhibitors for stress ulcer prophylaxis in patients undergoing otolaryngology-head and neck surgery in Beijing Tongren Hospital affiliated to Capital Medical University.Methods Referring to the rules of Beijing Hospital Management Center for reviewing special medical orders for preventive use of proton pump inhibitors during perioperative period,the rationality of proton pump inhibitors for stress ulcer prophylaxis in patients undergoing otolaryngology-head and neck surgery was evaluated,and logistic regression was used to analyze the factors affecting the rationality.Results A total of 327 hospitalized patients were included.The reasonable rate of proton pump inhibitors for stress ulcer prophylaxis was 52.3%,and the reasonable rate was 60.9%,77.7%and 85.0%in terms of indications,dosage and course of medication respectively.Logistic regression analysis showed that the rationality of proton pump inhibitors for stress ulcers prophylaxis was positively correlated with hypertension(OR=2.528,95%CI:1.219 to 5.243)and negatively correlated with surgery time greater than three hours(OR=0.024,95%CI:0.012 to 0.046).Conclusion The Department of Otolaryngology-Head and Neck Surgery at this hospital has the problem that the use of proton pump inhibitors for stress ulcer prophylaxis is unreasonable in surgical patients,and it is necessary to further formulate standardized management measures to promote the clinical rational use of stress ulcer prophylaxis in patients undergoing otolaryngology-head and neck surgery.

关 键 词：质子泵抑制剂 预防 合理性 影响因素 

分 类 号：R975.2[医药卫生—药品] R969.3[医药卫生—药学]