我院肿瘤患者止吐药物使用合理性与疗效分析

发布时间：2018-11-23 21:06

【摘要】：目的:为肿瘤患者止吐药物的合理使用提供参考。方法:通过医院集成医疗终端管理系统(EMRS)收集我院肿瘤科2015年10月-2016年6月使用止吐药物患者的医嘱共2 616份,对其使用合理性进行统计分析并评价其疗效。结果:在调查的2 616例病例中,符合纳入排除标准的病例有1301例,其中595例、合计760例次患者存在不合理用药现象,主要包括药物选择不适宜(33.82%)、用法用量不合理(25.26%)、联合用药不恰当(34.08%)、用药疗程不规范(6.84%)。女性患者的恶心发生率高于男性,差异有统计学意义(P=0.003),而不同性别患者的呕吐发生率则差别不大(P0.05);不同年龄患者的恶心、呕吐发生率均差别不大(P0.05);合理用药组的恶心、呕吐控制率均高于不合理用药组。不同催吐风险化疗药物止吐治疗合理用药组的成本均值均低于不合理用药组,提示止吐药合理使用能在保证治疗效果的同时减轻患者的经济负担。结论:临床应根据化疗药的催吐风险分级合理选用止吐方案,联合化疗患者应根据最高催吐风险的化疗药物选择止吐方案,严格掌握止吐药用法用量和疗程,并在选择止吐方案时综合考虑患者的治疗费用,保障患者用药安全、有效、经济、合理。
[Abstract]:Objective: to provide reference for rational use of antiemetic drugs in cancer patients. Methods: from October 2015 to June 2016, a total of 2 616 medical orders from oncology department of our hospital were collected through the hospital integrated medical terminal management system (EMRS). The rationality of the use of antiemetic drugs was statistically analyzed and its curative effect was evaluated. Results: of the 2 616 cases investigated, 1301 cases met the exclusion criteria, among which 595 cases were found to have unreasonable drug use, including improper drug selection (33.82%). The usage was unreasonable (25.26%), the combined use was inappropriate (34.08%) and the course of treatment was not standardized (6.84%). The incidence of nausea in female patients was significantly higher than that in men (P0. 003), but there was no significant difference in the incidence of vomiting between women and men (P0.05). The incidence of nausea and vomiting in patients of different ages were not different (P0.05); the control rate of nausea and vomiting in the rational medication group was higher than that in the irrational drug group. The average cost of different risk chemotherapeutic drugs for antiemetic therapy was lower than that of irrational medication group, which suggested that rational use of antiemetic drugs could reduce the economic burden of patients while ensuring the therapeutic effect. Conclusion: according to the risk classification of the chemotherapeutic agents, the antiemetic regimen should be selected reasonably in clinic, and the combination chemotherapy should select the antiemetic regimen according to the highest risk of exocytosis, and strictly master the dosage and course of antiemetic medicine. In the selection of antiemesis plan, the cost of treatment is considered comprehensively to ensure the safety, efficiency, economy and rationality of drug use.
【作者单位】：南京军区福州总医院药学科;
【分类号】：R975.4

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