55例儿童使用注射用甲泼尼龙琥珀酸钠致不良反应的分析及对策  

Analysis and Countermeasures of Adverse Reactions Induced by Methylprednisolone Sodium Succinate for Injection in 55 Children

作　　者：刘飞 胡静 郑爱斌 LIU Fei;HU Jing;ZHENG Ai-bin(Changzhou Children's Hospital,Changzhou 213003,China)

机构地区：[1]常州市儿童医院,常州213003

出　　处：《中国合理用药探索》2023年第11期55-60,共6页Chinese Journal of Rational Drug Use

摘　　要：目的:分析某院儿童使用注射用甲泼尼龙琥珀酸钠致药品不良反应(ADR)的发生特点及规律,为临床儿童合理安全使用糖皮质激素类药物提供参考。方法:收集该院从2013年4月~2023年3月期间上报的国家药品不良反应监测系统中的55例使用注射用甲泼尼龙琥珀酸钠致ADR患儿的基本信息,包括性别、年龄、原患疾病、给药途径、ADR发生时间、累及器官/系统和主要临床表现、采取的解决措施以及病情的转归情况,并进行统计分析。结果:55例ADR报告中,男女比例为1.89∶1;患儿年龄主要集中在3岁以下(44例,80.00%);原患疾病主要为呼吸系统疾病(53例,96.36%),给药方式均为静脉滴注;ADR发生时间主要集中在用药后30min内(51例,92.73%);主要累及皮肤及皮肤附件疾病、血液系统疾病、胃肠疾病、呼吸系统疾病、代谢及营养疾病、免疫疾病及感染,以皮疹、瘙痒等为主要症状的皮肤反应最多见(44例,80.00%);发生ADR后主要采取停药、给予对症治疗(40例,72.72%)等处理措施,患儿均好转或痊愈,未对原患疾病造成明显影响。结论:临床需重视儿童使用甲泼尼龙琥珀酸钠等糖皮质激素类药物导致的ADR,用药过程中需密切关注患儿出现的症状并及时进行处理,避免严重ADR的发生,确保患儿安全合理用药。Objective:To analyze the occurrence characteristics and regularity of adverse drug reactions(ADRs)induced by methylprednisolone sodium succinate for injection in children in a hospital,so as to provide reference for the clinical rational and safe use of glucocorticoids in children.Methods:The general information of 55 children with ADRs,that were attributed to methylprednisolone sodium succinate for injection and reported to the National Center for ADR Monitoring from April 2013 to March 2023,were collected and analyzed statistically with regard to sex,age,primary disease,route of administration,occurrence time of ADRs,organs/systems involved,main clinical manifestations,measures taken,and outcome of the disease.Results:Among the 55 patients in the ADR reports,the male-to-female ratio was 1.89:1,the pediatric patients were predominantly younger than 3 years(44 patients,80.00%),the primary disease was mainly respiratory disease(53 patients,96.36%),the route of administration was intravenous drip,the occurrence time of ADRs was generally within 30 minutes after administration(51 patients,92.73%),the main diseases involved skin and skin appendages,hematological,gastrointestinal,respiratory,metabolic and nutritional and immune disorders,as well as infections,with rash and pruritus being the presenting symptoms of skin reactions(44 patients,80.00%),and the measures taken were mainly drug withdrawal and symptomatic treatment upon the occurrence of ADRs(40 patients,72.72%).All the patients were improved or recovered,and there was no significant impact on the primary disease.Conclusion:Great importance should be attached to ADRs in children caused by clinical use of glucocorticoids such as methylprednisolone sodium succinate for injection,and close attention should be paid to the children's symptoms with timely treatment provided,so as to avoid the occurrence of serious ADRs and ensure the safe and rational use of drugs in children.

关 键 词：注射用甲泼尼龙琥珀酸钠 药品不良反应 糖皮质激素 儿童 合理用药 

分 类 号：R969.3[医药卫生—药理学]