【摘要】 目的:了解桂林市人民医院(以下简称"我院")中药注射剂医嘱不合理用药情况,为进一步规范中药注射剂的临床合理使用提供参考。方法:通过我院住院系统电子病历平台,选取2016年1月1日至2019年8月30日已归档的使用中药注射剂的出院患者(住院时间>3 d)的电子病历1 000份,对中药注射剂不合理用药医嘱采用帕累托图法分析,并筛选出主要因素、次要因素及一般因素。结果:1 000份中药注射剂病历中,658份存在不合理用药情况(占65. 80%);不合理用药累计879频次,涉及8种不合理用药类型,其中频次数排序居前3位的为用量不适宜、选择溶剂不适宜和适应证不适宜,构成比分别为27. 99%(246频次)、25. 82%(227频次)和18. 66%(164频次),经帕累托图分析,三者为主要因素;次要因素为未单独使用;一般因素为存在有配伍禁忌的药物接瓶输注而不冲管、遴选药品不适宜、疗程不当及重复用药。结论:采用帕累托图法对我院中药注射剂不合理用药医嘱进行分析,筛选出主要因素、次要因素及一般因素,临床药师可对出现的不合理用药因素进行实时监测,并制订相应的干预措施如处方专项点评,以促进中药注射剂的合理使用。更多还原

【Abstract】 OBJECTIVE: To investigate the irrational drug application in medical orders of tradition Chinese medicine injection in Guilin People’s Hospital(hereinafter referred to as "our hospital"),so as to provide references for further standardizing the clinical rational application of traditional Chinese medicine injections. METHODS:Through the inpatient electronic medical record platform of our hospital,1 000 pieces of filed electronic medical records of discharged patients from Jan. 1 st,2016 to Aug. 30 th,2019 who were treated with tradition Chinese medicine injection(hospital stay>3 days) were extracted,Pareto diagram method was adopted to analyze irrational medical orders of tradition Chinese medicine injection,so that the main factors,secondary factors and general factors were screened out. RESULTS: Of the 1 000 pieces of medical history of tradition Chinese medicine injection,there were irrational medication in 658 pieces(65. 80%),there were 879 case-times of irrational medication in total,involving 8 types,the top 3 types ranked by cases were respectively inappropriate dosage,improper solvent selection and inaptitude indications, with the constituent ratios were respectively 27. 99%(246 case-times), 25. 82%(227 case-times) and 18. 66%(164 case-times),which were the main factors after Pareto diagram analysis,the secondary factor was not used alone,the general factors were incompatible drugs infusion without tube flushing,improper drug selection,inappropriate treatment course and repeated medication. CONCLUSIONS: Using Pareto diagram method to analyze the irrational medical orders of tradition Chinese medicine injection and screen out the main factors,secondary factors and general factors,so that clinical pharmacists can conduct real-time monitoring on irrational medication factors, and formulate corresponding intervention measures such as specific reviews of prescriptions to promote the rational application of tradition Chinese medicine injection.更多还原