中国药物警戒 ›› 2023, Vol. 20 ›› Issue (9): 1022-1026.
DOI: 10.19803/j.1672-8629.20220741

• 安全与合理用药 • 上一篇    下一篇

质子泵抑制剂预防胆胰外科围术期应激性黏膜病变的合理性评价

黎杏仁1, 沈爱宗2, 苏丹3,*   

  1. 1宿松县中医院药剂科,安徽 安庆 246000;
    2中国科学技术大学附属第一医院药学部,安徽 合肥 230000;
    3中国科学技术大学附属第一医院健康管理中心,安徽 合肥 230000
  • 收稿日期:2022-12-30 出版日期:2023-09-15 发布日期:2023-09-14
  • 通讯作者: * 苏丹,女,博士,主任药师,临床药学与抗感染药物研究。E-mail: dansu@ustc.edu.cn
  • 作者简介:黎杏仁,女,本科,主管药师,临床药学。
  • 基金资助:
    重大新药创制国家科技重大专项2020年度（2020ZX09201-004）; 中国科学技术大学校级本科质量工程项目（重点项目）：（2021xjyxm090）; 高等学校省级质量工程项目：（2021jyxm1799）

Evaluation of the rationality of proton pump inhibitors in preventing perioperative stress related mucosal disease in biliary and pancreatic surgery

LI Xingren1, SHEN Aizong2, SU Dan3,*   

  1. 1Pharmacy Department of Susong County Traditional Chinese Medicine Hospital, Anqing Anhui 246000, China;
    2Department of Pharmacy, The First Affiliated Hospital of University of Science and Technology of China, Hefei Anhui 230000, China;
    3Health Management Center, The First Affiliated Hospital of University of Science and Technology of China, Hefei Anhui 230000, China
  • Received:2022-12-30 Online:2023-09-15 Published:2023-09-14

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摘要： 目的 调查胆胰外科围术期使用质子泵抑制剂（PPIs）预防应激性溃疡（SU）的情况,评价其合理性,为PPIs的合理应用提供参考。方法 采用回顾性调查研究的方法,收集某院2020年6月1日至8月31日胆胰外科围术期使用了PPIs 的患者信息,统计PPIs的使用率、用药指征,随后评价有用药指征病例的药物遴选、用药时机、用法用量等情况。结果 623例次手术,有530例次478名患者预防使用了PPIs（85.07%）。其中无PPIs用药指征的为268例次（50.57%）,262例次有用药指征病例产生不合理用药情况642例次（98.32%）,主要为遴选药物不适宜、用药时机不适宜、用药频次不适宜、疗程过长等,仅11例次（1.68%）相对合理。结论 该院胆胰外科围术期使用 PPIs 预防SU不合理现象显著,医师应从严把控用药指征,药师应加强前置性处方审核,共同促进药物合理使用。

关键词: 胆胰外科, 质子泵抑制剂, 围术期, 应激性黏膜病变, 应激性溃疡, 预防, 合理用药

Abstract: Objective To evaluate the rationality of proton pump inhibitors (PPIs) in the prevention of stress ulcer（SU） during perioperative period of biliary and pancreatic surgery, and to provide reference for the rational use of PPIs. Methods A retrospective survey was conducted to collect information on 478 patients who used PPIs during the perioperative period in the Department of Biliary and Pancreatic Surgery of a certain hospital from June to August 2020. The usage rate and medication indications of PPIs were statistically analyzed. Subsequently, drug selection, medication timing, usage and dosage of cases with medication indications were evaluated. Results Among 623 surgeries, PPIs were used for prevention in 530 cases, accounting for 85.07% of the cases. Among them, 268 cases (50.57%) had no indication of PPIs medication. The cases with medication indications, were mainly due to inappropriate drug selection, inappropriate timing of administration, inappropriate frequency of administration, and overly long treatment periods. The majority of patients exhibited multiple inappropriate medication situations, with only 11 cases (2.08%) being relatively rational. Conclusion The unreasonable phenomenon of using PPIs to prevent stress ulcer in the perioperative period of biliary and pancreatic surgery in the hospital is significant. Physicians should strictly control medication indications, and pharmacists should strengthen pre prescription review to jointly promote rational drug use.

Key words: pancreato-biliary surgery, proton pump inhibitors, perioperative, stress related mucosal disease, stress ulcer, prophylaxis, rational use of drug

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