经腹腔镜胆囊切除术患者预防应激性溃疡的用药分析

目的:对腹腔镜下胆囊切除术患者预防应激性溃疡的用药情况进行合理性分析,促进临床合理用药。方法:利用某院合理用药监管系统,采用回顾性调查方法,收集某院2012-2013年行腹腔镜下胆囊切除术的患者病历,对预防应激性溃疡的药物应用情况进行统计、分析。结果:2012-2013年行腹腔镜下胆囊切除术的患者共1 935例,最终纳入研究的1 600例患者中,有682例(42.63%)应用抑酸药进行应激性溃疡预防,其中质子泵抑制剂(PPIs)的使用率高达99.27%;466例(68.33%)患者为无指征预防性应用抑酸药;所有预防用药患者均采用静脉注射给药,其中有1例患者同时使用了PPIs和H₂受体拮抗剂(H₂RAs)。结论:该院应激性溃疡预防用抑酸药PPIs存在过度使用及药物品种、剂型选择不规范等现象。建议临床使用抑酸药PPIs预防应激性溃疡时应严格掌握用药指征,规范用药行为,促进临床合理用药。

Analysis of medication for stress ulcer prophylaxis in patients receiving laparoscopic cholecystectomy

OBJECTIVE To reasonably analyze medications for stress ulcer (SU) prophylaxis in patients receiving laparoscopic cholecystectomy (LC), to promote clinical rational drug use. METHODS A hospital regulatory system for rational use of drugs was utilized and a retrospective survey method adopted, to collect medical cases of patients receiving LC from 2012 to 2013 in a hospital, for statistics and analysis of drugs application against SU. RESULTS A total of 1935 LC patients from 2012 to 2013 were found out, 1600 of them were finally included into the study. Of these patients, 682 patients (42.63%) received acid inhibitor, 99.27% of them used proton pump inhibitors (PPIs); 466 patients (68.33%) received acid inhibitors without indications. All preventive drugs were administered via intravenous injection, and 1 patient simultaneously received PPI and H₂ receptor antagonists (H₂RAs). CONCLUSION This hospital has phenomena of overuse of acid inhibitor PPIs against SU, irregular selection of drug category and dosage form. It is suggested that the indications should be strictly followed for acid inhibitor PPIs for SU prophylaxis, and medication should be standardized to promote clinical rational drug use.