基于属性层次模型的血必净注射液标准的建立及临床应用  

Establishment of Xuebijing Injections standard based on hierarchical attribute model and clinical application

作　　者：余庆 詹三华[1] 赵杰 夏茹楠 张红 张鹏程 赵欢欢 梁海[2] YU Qing;ZHAN Sanhua;ZHAO Jie;XIA Ru’nan;ZHANG Hong;ZHANG Pengcheng;ZHAO Huanhuan;LIANG Hai(Department of Pharmacy,People’s Hospital of Tongling,Tongling 244000,China;Department of Pharmacy,People’s Hospital of Bozhou,Bozhou 236800,China)

机构地区：[1]铜陵市人民医院药学部,铜陵244000 [2]亳州市人民医院药学部,亳州236800

出　　处：《西北药学杂志》2025年第2期232-239,共8页Northwest Pharmaceutical Journal

基　　金：安徽省重点研究与开发计划项目(编号:2022e07020066);安徽医科大学青年科学基金项目(编号:2021xkj095)。

摘　　要：目的建立血必净注射液合理性评价标准,分析其不合理用药情况,为临床合理、规范应用该药提供参考。方法参考药品说明书、专家共识和指南等制定血必净注射液合理性评价细则,根据纳入标准与排除标准,随机抽取铜陵市人民医院血必净注射液用药频度(defined daily doses,DDDs)排名前5科室的282例归档病历,应用属性层次模型(attribute hierarchy model,AHM)对其进行合理性评价。结果282例病历主要分布在重症医学科、呼吸与危重症医学科、急诊科、普外科和感染科,其中优秀病历[病历评分(medical record score,MRS)≥90分]为13例(4.61%),良好病历(75分≤MRS<90分)为183例(64.89%),合格病历(60分≤MRS<75分)为72例(25.53%),不合格病历(MRS<60分)为14例(4.96%)。不合理类型主要表现为无适应证28例(9.93%),无中医辩证用药18例(6.38%),用法用量不合理37例(13.12%),联合用药不合理30例(10.64%)。结论基于AHM法制定的血必净注射液标评价方法切实可行,评价结果显示该院血必净注射液临床应用基本合理,但存在无适应证、无中医辩证用药及用法用量不合理等现象,应进一步加强处方前置审核和处方点评,提高临床用药合理性。Objective To establish a rational evaluation standard for Xuebijing Injections and to analyze instances of unreasonable drug use,thereby provide a reference for its rational clinical application.Methods A rational dosing evaluation system was formulated based on drug specifications,expert recommendations,guidelines and other relevant documents.Utilizing these criteria,the attribute hierarchy model(AHM)was employed to evaluate the discharge medical records of 282 patients administered Xuebijing Injections from July 2022 to June 2023 at Tongling People’s Hospital.Results The distribution of the 282 medical records was predominantly within the departments of critical care medicine,respiratory and critical care medicine,emergency medicine,general surgery,and infectious diseases.Among these cases,excellent medical records(MRS≥90 points)were 13 cases(4.61%),good medical records(75 points≤MRS<90 points)were 183 cases(64.89%),qualified medical records(60 points≤MRS<75 points)were 72 cases(25.53%)and unqualified medical records(MRS<60 points)14 cases(4.96%).The primary types of unreasonable use included 28 cases of medication without indication(9.93%),18 cases lacking traditional Chinese medical dialectical medication(6.38%),37 cases of unreasonable usage and dosage(13.12%),and 30 cases of unreasonable drug combination(10.64%).Conclusion The evaluation method for the reasonableness of Xuebijing Injections,based on the AHM approach,is deemed feasible.The evaluation results indicate that the use of this drug in the hospital is generally reasonable;however,issues such as lack of indication,absence of traditional Chinese medical dialectical medication,and concerns regarding usage and dosage were identified.It is recommended that hospitals further standardize prescription pre-review and commentary processes to enhance the rationality of clinical drug use.

关 键 词：属性层次模型 血必净注射液 合理性评价 处方前置审核 处方点评 

分 类 号：R969.3[医药卫生—药理学]