医院麻醉药品的管理使用现状以及干预分析

发布时间：2018-04-14 23:04

本文选题：麻醉药品 + 癌痛规范化治疗　；参考：《中国当代医药》2017年26期

【摘要】：目的研究医院麻醉药品管理使用现状和临床干预效果。方法我院从2013年1月开展癌痛规范化治疗示范病房,在施行开展癌痛规范化治疗1年后,从我院信息管理系统中抽取开展示范病房前后的麻醉处方(各3600张)及癌症镇痛(含辅助镇痛)处方(各1800张),根据世界卫生组织癌痛三阶梯镇痛原则对药品的用药频度进行分析。结果在癌痛第三阶梯药物中,阿片类的硫酸吗啡缓释片、盐酸吗啡片和盐酸羟考酮缓释片在干预前后均排在前三位,是中重度疼痛、爆发性疼痛及剂量滴定的首选用药。癌痛第二阶梯镇痛药物的消耗量在干预后略有降低,在中度疼痛患者中主张应用小剂量的第三阶梯镇痛药,是导致第二阶梯镇痛药用量降低的直接原因。第一阶梯药物和辅助性镇痛药物在干预后呈上升趋势,干预后辅助性镇痛药阿米替林片与卡马西平片的用量明显增加,临床上辅助性镇痛药与镇痛药联合应用得到了重视。结论通过建立癌痛规范化示范病房对医院麻醉药品的管理使用现状进行干预,根据世界卫生组织三阶梯镇痛原则进行合理干预,可使癌症患者获益,癌痛规范化治疗的经验可在临床中推广。
[Abstract]:Objective to study the current situation of management and use of narcotic drugs in hospitals and the effect of clinical intervention.Methods from January 2013, the demonstration ward for standardized treatment of cancer pain was carried out in our hospital, and one year after the standardized treatment of cancer pain was carried out in our hospital,Anesthetic prescriptions (3600) and cancer analgesia (including auxiliary analgesia) prescriptions (each 1800) were extracted from the information management system of our hospital before and after the demonstration ward.The frequency of drug use was analyzed.Results among the third step drugs for cancer pain, opioid morphine sulfate sustained release tablets, morphine hydrochloride tablets and hydroxycodone hydrochloride sustained release tablets were the first three drugs before and after intervention. They were the first choice for moderate and severe pain, explosive pain and dose titration.The consumption of the second step analgesic drugs for cancer pain decreased slightly after intervention, and the use of the third step analgesic drugs in the patients with moderate pain was the direct reason leading to the decrease of the dosage of the second step analgesic drugs.After intervention, the dosage of amitriptyline tablet and carbamazepine tablet increased obviously. The combination of adjuvant analgesics and analgesic drugs was paid more attention in clinic.Conclusion through the establishment of standardized demonstration ward for cancer pain, the management and use of narcotic drugs in hospitals should be interfered with, and reasonable intervention based on the three-step analgesia principle of the World Health Organization could benefit cancer patients.The experience of standardized treatment of cancer pain can be popularized in clinic.
【作者单位】：福建医科大学附属漳州医院药学部;
【分类号】：R95

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