小汤山医院680例SARS患者药物利用分析

目的调查分析小汤山医院680例临床确诊SARS患者治疗期间的药物利用情况. 方法采用HIS系统回顾性分析小汤山医院临床确诊的680例SARS患者的病案及用药记录,分别运用计算机病例分型模型(A、B、C、D型)和临床分型模型(普通型、重症型)分组,统一采用合理用药指标:限定成人日剂量(defined daily dose, DDD)、药物利用指数(drug utilization index, DUI)、用药例次数、医嘱数及人均药费、日均药费等,评价各组间的差异. 结果 680例SARS患者共计应用17大类359种药物,应用病例数最多的是抗菌药物.应用经费最多的是糖皮质激素和大输液类药物.DDDs排序最高的为免疫调节剂和维生素药物.应用总天数最多的是大输液和维生素类药物.药费最高的是甲基强的松龙注射剂.C型、D型和重症型SARS患者的年龄、死亡率、用药品种、用药频次及经费均显著高于A型和普通型SARS患者. 结论按WHO推荐的合理用药指标DUI＝1标准,359种药物中DUI小于、等于和大于1的比例分别为37%、30%和33%.抗病毒药用量不足,激素类用量过大.计算机病例分型客观真实、速度快、易标化,具有推广潜质.

Utilization Analysis of Drug Efficacy of the 680 Cases of SARS Patients in Xiao Tang Shan Hospital of PLA

Objective To study the medication usage in patients with severe acute respirato r y syndrome (SARS). MethodsThe information o f the medications of 680 patients with SARS in Xiao Tang Shan Hospital was collec ted by HIS system and classified by using computer model on the basis of disease factor. The usage time and cases, and cost of these medications were calculated . The defined daily dose (DDD) and drug utilization index (DUI) were analyzed. ResultsA number of 359 drugs in 17 categories w ere applied to 680 patients with SARS. Most cases used antibacterial agents, the DDDs of immunomodulator and vitamins were the highest, the usage duration of vi tamins and infusion fluids were the longest among 17 kinds of the drugs. The cos t of methylpredni-solone injection was the highest. The mortality rate , kinds o f drugs and frequency of drugs were JP3 higher in type C, type D and serious SARS patients than that of type A and common SARS patients.Conclusi ons Many kinds of medications have been prescribed to SA R S patients. The dosages of these medication are very high, JP especially gluc ocorticoids, immuneomodulator and nutrient agents. The computer model on the bas is of disease factor is probably valid, rapid and easy to standardize.