我院骨科患者围术期质子泵抑制剂预防应激性溃疡的合理性分析

发布时间：2018-01-25 18:48

本文关键词： 质子泵抑制剂应激性溃疡围术期合理用药　出处：《中国药房》2017年32期 　论文类型：期刊论文

【摘要】：目的:分析我院骨科围术期患者使用质子泵抑制剂(PPIs)预防应激性溃疡的合理性,以期为临床合理使用PPIs提供参考。方法:抽取2016年11月1-30日骨科出院手术患者病历,统计PPIs使用情况、患者基本情况、手术情况及是否存在应激性溃疡发生的应激源和危险因素,综合分析PPIs使用的合理性。结果:664例手术患者中有210例使用了PPIs,74例使用了H2受体拮抗药(H2RA),总预防用药率达42.77%;手术类型主要为骨折内固定术(74例,35.24%)和椎间盘切除术或髓核摘除术(38例,18.11%)。210例使用了PPIs的患者中,100%选择了PPIs注射剂,其中68例(32.38%)患者不具备预防用药指征,128例(60.95%)患者给药时机错误,74例(35.24%)患者给药频次错误,44例(20.95%)患者预防用药疗程超过3 d。结论:骨科患者围术期使用PPIs预防应激性溃疡时,存在适应证、品种选择、用法用量、疗程等方面的严重不合理现象,临床医师和监管者应高度重视,避免PPIs的过度应用。
[Abstract]:Objective: to analyze the Department of orthopedics of our hospital patients with perioperative use of proton pump inhibitors (PPIs) reasonable prevention of stress ulcer, so as to provide reference for clinical rational use of PPIs. Methods: from November 2016 1-30, the Department of orthopedics of hospital medical records patients, statistical PPIs usage, the basic situation of patients, surgery and the presence of stressors and risk factors of stress ulcer, the rationality of comprehensive analysis using PPIs. Results: 664 patients in 210 cases with PPIs, 74 cases of the use of the H2 receptor antagonist (H2RA), total preventive medication rate was 42.77%; the operation is the main type of fracture fixation (74 cases, 35.24%) and intervertebral disc excision or discectomy (38 cases, 18.11% cases of the use of the PPIs.210) patients, 100% chose PPIs injection, including 68 cases (32.38%) patients with preventive medication indications, 128 cases (60.95%) were administered in 74 cases (35.2 time error. 4%) with the frequency of administration errors, 44 cases (20.95%) patients with prophylaxis treatment of more than 3 d. conclusion: Department of orthopedics perioperative use of PPIs for the prevention of stress ulcer, there are indications, variety selection, usage and dosage, serious unreasonable treatment, clinicians and regulators should pay attention to avoid excessive application PPIs.

【作者单位】：第四军医大学第一附属医院药剂科;
【基金】：国家高技术研究发展计划(863计划)课题(No.2012AA02A603) 军队“十一五”重大专项课题(No.06D007)
【分类号】：R975
【正文快照】： 应激性溃疡(Stress ulcer,SU)是指机体在各类严重创伤、大型手术、危重疾病等严重应激状态下,发生的急性消化道糜烂、溃疡、出血等病变,最后可导致消化道出血、穿孔,并使原有病变恶化[1-2]。一般来说,原发病越重,SU的发生率和病死率越高。骨科术后诱发SU的事件屡有报道[3],因

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