癌痛规范化示范病房中癌痛治疗药物的用药分析

目的了解某三甲医院肿瘤科癌痛治疗药物的使用情况,以提高癌痛治疗药物合理使用的水平。方法采用回顾分析法,统计分析某医院肿瘤科住院患者2014~2018年癌痛治疗药物的金额,DDDs、构成比及癌痛病例抽查点评。结果癌痛治疗药物中三阶梯强阿片类药物的销售总金额及DDDs都位居首位;2015年"癌痛规范化治疗病房"评审活动以来,强阿片药物金额构成比占90%以上,DDDs构成比占74%以上;剂型以无创途径给药为主,DDDs构成比在95%以上,注射剂型的DDDs构成比低于5%;三阶梯强阿片类用药中,速效吗啡DDDs构成比低于4%,2015年以后芬太尼透皮贴剂DDDs构成比在60%~80%之间,羟考酮缓释片DDDs构成比在17%~35%之间,吗啡缓释片DDDs构成比小于2%;通过评审活动,该肿瘤病区癌痛治疗用药不合理情况明显减少。结论该肿瘤病区癌痛治疗用药符合WHO三阶梯止痛原则。

Analysis on the use of cancer pain therapeutic drugs in cancer pain standardized demonstration ward

Objective To investigate and analyze the application of analgesics for patients with cancer pain in oncology of a grade three and firstclass hospital,in order to improve the level of reasonable use of cancer pain analgsics.Methods With retrospective method,the datas of analgesics used for inpatients with cancer pain in oncology from 2014 to 2018 were calculated statistically in respect of the sales amount,frequency of drug sue(defined daily doses,DDDs),composition ratio and spot checked on cancer pain cases.Results The total sales amount and DDDs of opioids in cancer pain treatment drugs ranked first;From 2015,the oncology have establishment of the pain management ward(GPM-ward),The proportion of strong opioid drugs accounts for more than 90%,and the proportion of DDDs accounts for more than 74%.The dosage form is mainly administered by a non-invasive route,the ratio of DDDs is more than 95%,and the ratio of DDDs of the injectable dosage form is less than 5%;In the three-step strong opioid,the composition ratio of fast-acting morphine DDDs is less than 4%.After 2015,the composition ratio of fentanyl transdermal patch DDDs is between 60%and 80%,the composition ratio of oxycodone sustained-release tablets DDDs is between 17%and 35%,and the ratio of DDDs of morphine sustained-release tablets is less than 2%.Through the review activities,the unreasonable treatment of cancer pain in Oncology was significantly reduced.Conclusion The cancer pain treatment in oncology is consistent with the principles of 3 steps proposed by the WHO.