2005-2007年我院慢性阻塞性肺疾病住院患者用药分析

目的：了解我院慢性阻塞性肺疾病（COPD）患者的用药情况,探讨该疾病在我院的药物基本治疗方案及其用药合理性。方法：对2005-2007年呼吸科诊断为COPD的病历进行回顾分析,对抗菌药物、相关治疗药物的使用情况进行统计分析,依照《慢性阻塞性肺疾病诊治指南》评价我院呼吸科治疗COPD药品使用及利用的合理性。结果：98.5%的患者在治疗过程中使用抗菌药物;67.1%的患者在使用抗生素过程中更换了品种,其中有指征更换比例占91.9%,60.3%的患者采用了联合应用抗菌药物治疗、消除呼吸道症状的治疗,使用了支气管扩张剂、祛痰药、糖皮质激素、辅助呼吸衰竭治疗及氧疗。此外85.1%的患者同时使用了中药进行治疗。结论：我院治疗COPD用药结构与＂指南＂基本一致,药品的使用及利用基本合理,但仍存药敏检查比例较低、药物使用剂量过度、超长使用抗菌药物、使用抗菌药物档次偏高、糖皮质激素的使用时间过长等问题,应加强合理用药。

Drug Use in Inpatients with Chronic Obstructive Pulmonary Disease in Our Hospital During 2005～2007

OBJECTIVE： To probe into the drug use in the patients with chronic obstructive pulmonary disease （COPD） in our hospital and study the basic medicine treatment program and its medication rationality about this disease in our hospital. METHODS： The medical records of patients who were diagnosed as having COPD by our respiratory department from 2005 to 2007 were reviewed in respect of the use of antibacterials and other related medicines. The rationality of drug use/utilization in COPD patients in the respiratory department of our hospital was evaluated in accordance with the Diagnosis and Treatment Guidelines about COPD. RESULTS： 98.5% patients used antibacterials during the treatment; 67.1% patients changed medicines during the process of using antibiotics, of which, 91.9% had indications for drug change, and 60.3 % patients used antibacterials in combination. Bronchodilator, expectorant drugs and glucocorticoid, auxiliary treatment to respiratory failure and oxygen therapy were adopted for eliminating the respiratory symptoms. 85.1% of the patients received Chinese medicines concurrently. CONCLUSION： The medication structure for treating COPD in our hospital is basically in accordance with the Guidelines, and the application and utilization of medicines is basically reasonable, but there are still some problems such as the proportion of patients receiving drug sensitivity test is low, the use of antibacterials is too long, the grade of the used antibacterias is high, and the duration of using glucocorticoids is too long etc. Rational drug use should be strengthened.