303例肝胆胰外科患者围手术期气道管理药物应用分析  

Application of Airway Management Drugs in 303 Patients Undergoing Hepatobiliary and Pancreatic Surgery During Perioperative Period

作　　者：孟慧杰 颜妍 冀召帅 胡永芳 毛乾泰 艾超 MENG Huijie;YAN Yan;JI Zhaoshuai;HU Yongfang;MAO Qiantai;AI Chao(Dept.of Pharmacy,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China)

机构地区：[1]清华大学附属北京清华长庚医院/清华大学临床医学院药学部,北京102218

出　　处：《中国医院用药评价与分析》2023年第9期1131-1134,共4页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:调研肝胆胰外科患者围手术期气道管理药物的使用情况。方法:回顾性收集2022年1—3月该院肝胆胰外科手术患者的资料,分析患者围手术期气道管理药物使用情况,并比较有无术后肺部并发症(PPC)的患者在用药合理性和经济学方面的差异。结果:共纳入303例肝胆胰外科手术患者,以出院诊断为判定标准,PPC发生率为7.52%(23例);手术中使用气道管理药物的患者有109例(占35.97%),人均使用气道管理药物2.81种;有药物治疗相关问题的医嘱共151项,主要包括给药剂量不适宜、给药频率不适宜。与无PPC的患者(280例,使用气道管理药物医嘱共622项)比较,出现PPC患者(23例,使用气道管理药物医嘱共131项)的药物使用合理率更低[73.28%(96/131)vs.81.35%(506/622)],住院时间更长(中位数:15.0 d vs.9.5 d),住院费用更高(中位数:3.7万元vs.2.9万元),药品费用更高(中位数:2.4万元vs.0.6万元),差异均有统计学意义(P<0.05)。结论:该院肝胆胰外科出现PPC的手术患者气道管理药物使用合理率低于无PPC的患者,住院时间长于无PPC的患者,住院费用、药品费用均高于无PPC的患者。临床应提高气道管理药物的使用合理性,以降低PPC发生率和医疗费用。OBJECTIVE:To investigate the application of airway management drugs in patients undergoing hepatobiliary and pancreatic surgery during the perioperative period.METHODS:Data of patients undergoing hepatobiliary and pancreatic surgery in the hospital from Jan.to Mar.2022 were retrospectively collected,and application of airway management drugs during perioperative period was analyzed.Rationality and economics of medication in patients with or without postoperative pulmonary complications(PPC) were compared.RESULTS:A total of 303 patients undergoing hepatobiliary and pancreatic surgery were included in the study.The incidence of PPC was 7.52%(23 patients) with discharge diagnosis as the criteria,airway management drugs were used during surgery in 109 patients(35.97%),with 2.81 airway management drugs used per capita.There were 151 medical orders with drug treatment related problems,mainly included inappropriate dosage and improper frequency.Compared with patients without PPC(280 patients with 622 medical orders for airway management drugs),patients with PPC(23 patients with 131 medical orders for airway management drugs) had lower rational rate of drug use [73.28%(96/131) vs.81.35%(506/622)],longer length of length of stay(median:15.0 d vs.9.5 d),higher hospitalization cost(median:37 000 yuan vs.29 000 yuan),and higher drug cost(median:24 000 yuan vs.6 000 yuan),the differences were statistically significant(P<0.05).CONCLUSIONS:In the department of hepatobiliary and pancreatic surgery,the rational rate of airway management drugs used in patients with PPC is lower than that in patients without PPC,the length of stay is longer than that in patients without PPC,and the hospital cost and drug cost are higher than those in patients without PPC.Clinical use of airway management drugs should be improved to reduce the incidence of PPC and medical costs.

关 键 词：术后肺部并发症 气道管理 药物 肝胆胰外科患者 

分 类 号：R974[医药卫生—药品] R977.11[医药卫生—药学]