蚌埠医学院第一附属医院1728例药品不良反应报告分析

目的了解蚌埠医学院第一附属医院药品不良反应（ADR）发生特点及监测工作的质量,探讨ADR监测工作存在的问题及持续改进措施。方法对蚌埠医学院第一附属医院2009~2011年上报的1728例ADR报告,分别按患者年龄与性别、报告人职业、引起ADR的药品种类、临床表现、给药途径、药品不良反应结果等方面进行统计、分析。结果1728例ADR报告中,严重的ADR 4例（0.23%）,新的ADR 35例（2.02%）;护士上报1654例（95.72%）,药师上报73例（4.22%）,医师上报仅2例（0.12%）;以静脉给药引发的ADR最多（占93.58%）;抗感染药物引起的ADR最多,有713例（占41.26%）;ADR临床表现以皮肤及其附件损害最为常见。结论医院应完善医、药、护合作的ADR监测体系,提高医师、临床药师的上报比例;加强严重的、新的ADR监测,降低漏报率;充分发挥临床药师的药学监护作用,确保临床安全、有效、合理用药。

Analysis of 1728 ADR Reports in the First Affiliated Hospital of Bengbu Medical College

Objective To investigate the characteristics of the adverse drug reaction（ADR）and the quality of monitoring in the First Affiliated Hospital of Bengbu Medical College and discuss the measures for continuous improvement to existing problems during work.Methods The 1728 cases of ADR reported from 2009 to 2011 in the hospital were collected and analyzed retrospectively in respects of age and gender of patients,occupation of reporters,species of ADR-inducing drugs,clinical manifestations,routes of administration,etc.Results Among 1728ADR cases,there were 4 serious cases（0.23%）,and 35new ADR cases（2.02%）.A total of 1654 cases were reported by nurses（95.72%）,73cases（4.22%）were reported by clinical pharmacists and only 2 cases（0.12%）were reported by physicians.For administration route,the majority of cases（1619,93.58%）were caused by intravenous administration. Among all drugs that caused ADR,antimicrobial drugs caused the most cases（713,41.26%）.The most common clinical manifestations of ADR were the lesions of skin and its appendants.Conclusion It is suggested that physicians,pharmacists and nurses work together to improve the ADR monitoring system in the hospital.The proportion of the ADR reported by physicians and pharmacists should be increased and the serious and new ADR should be closely monitored.The false negative rate of ADR must be reduced.The role of clinical pharmacists should be given full play in the pharmaceutical monitoring in order to ensure the safety,efficacy and rationality of clinical medication.