329例汶川地震妇女儿童伤病员药物利用分析
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摘要
目的调查分析四川大学华西第二医院收治329例汶川地震妇女儿童伤病员的药物利用情况。方法采集329例伤病员病历、处方及用药记录中疾病诊断和药物治疗相关数据,按照ICD-10标准进行疾病分类,根据WHO合理用药指标:限定成人日剂量(defined daily dose,DDD)、药物利用指数(drug utilization index,DUI)、用药例次数、人均费用等回顾性分析评价成人用药情况。同时,根据DDD评价原理设计儿童合理用药评价指标:CDDD(children defined daily dose)和CDUI(children drug utility index)来分析儿童用药情况。结果329例伤病员共使用25个类别的389种药物。应用例次数最多的是大输液类药物;用药金额最高的是抗微生物类药物和大输液类药物;用药总天数最多的是抗微生物类药物和维生素及矿物质类药物。其中妇产科用药频度(总限定日剂量数,DDDs)排序最高的是维生素及矿物质类药物和电解质平衡调节药物;DUI大于和小于1的比例分别为32.3%和47.2%,即同时存在用药过量和不足。109例0～1岁患儿用药过量情况严重,有40种药物CDUI>1,以强的松龙注射剂最高(CDUI=40～80)。结论震后妇女儿童伤病员医疗救治中存在不合理用药现象,亟需制定灾后紧急救治中药物治疗规范,提高用药安全性与合理性。儿科用药合理性评价方法是否适用于儿童用药合理性评价有待进一步研究。
Objective To study medication usage in women and children from the distress area related to the Wenchuan earthquake.Methods Information about which medications that 329 patients used in West China Second University Hospital,Sichuan University was collected by the HIS system and classified by using the ICD-10system.The cases and times of medication,the total number of drugs,the drug cost per capita,and the drug cost per day were calculated using Excel.The defined daily dose(DDD)and drug utilization index(DUI)were analyzed.According to the principle of DDD & DUI,CDDD & CDUI were designed to analyze the drugs used by children.Results A total of 398 drugs in 25 categories were applied to 329 patients.Every case used infusion solutions,the DDDs of vitamins were the highest,the usage and duration of vitamins and antibacterial agents were the longest among the 25 kinds of the drugs.The cost of Amoxicillin Sulbactam injection was the highest.Many kinds of medications were prescribed to these patients,the rate of DUI>1 vs DUI<1 are 32.3% &47.2%.The results of CDUI indicated overuse of drugs was serious in children less 1yr old.The CDUI of precortisyl was the highest:40 to 80.Conclusions The system for distribution of medication to patients to children and women during an emergency is flawed.According to our findings we make new suggestions for changes,which have to be proved by further research.
Objective To study medication usage in women and children from the distress area related to the Wenchuan earthquake.Methods Information about which medications that 329 patients used in West China Second University Hospital,Sichuan University was collected by the HIS system and classified by using the ICD-10system.The cases and times of medication,the total number of drugs,the drug cost per capita,and the drug cost per day were calculated using Excel.The defined daily dose(DDD)and drug utilization index(DUI)were analyzed.According to the principle of DDD & DUI,CDDD & CDUI were designed to analyze the drugs used by children.Results A total of 398 drugs in 25 categories were applied to 329 patients.Every case used infusion solutions,the DDDs of vitamins were the highest,the usage and duration of vitamins and antibacterial agents were the longest among the 25 kinds of the drugs.The cost of Amoxicillin Sulbactam injection was the highest.Many kinds of medications were prescribed to these patients,the rate of DUI>1 vs DUI<1 are 32.3% &47.2%.The results of CDUI indicated overuse of drugs was serious in children less 1yr old.The CDUI of precortisyl was the highest:40 to 80.Conclusions The system for distribution of medication to patients to children and women during an emergency is flawed.According to our findings we make new suggestions for changes,which have to be proved by further research.
引文
1张崖冰,胡善联.限定日剂量在药物经济学研究中的应用.卫生经济研究,2001,4:15-17.
2邹豪,邵元福,朱才娟.医药药品DDD数排序分析的原理及利用.中国药房,1996,7(5):215-217.
3ATC/DDD Index2008.Available from:URL:http://www.whocc.no/atcddd/indexdatabase/
4周帮旻,王莉,李幼平.成都市三圈7个乡镇和社区卫生服务机构药品使用现况调查—三圈七院六站预调查报告之三.中国循证医学杂志,2008,8(7):529-537
5韩璐,兰瑛,郭远超,等.7例汶川地震挤压综合征患儿用药分析.中国循证医学杂志,2008,8(9):710-712.
6杨造成,彭碧波,白晓东,等.赴巴基斯坦地震医疗救援药品保障的探讨.武警医学,2006,17(2):148-149.
7Roy N,Shah H,Patel V et al.Surgical and psychosocial outcomes in the rural injured-a follow-up study of the2001earthquake victims.Injury,2005,36(8):927-934.
8杨造成,彭碧波,白晓东,等.赴巴基斯坦地震医疗救援药品保障的探讨.武警医学,2006,17(2):148-149.
2邹豪,邵元福,朱才娟.医药药品DDD数排序分析的原理及利用.中国药房,1996,7(5):215-217.
3ATC/DDD Index2008.Available from:URL:http://www.whocc.no/atcddd/indexdatabase/
4周帮旻,王莉,李幼平.成都市三圈7个乡镇和社区卫生服务机构药品使用现况调查—三圈七院六站预调查报告之三.中国循证医学杂志,2008,8(7):529-537
5韩璐,兰瑛,郭远超,等.7例汶川地震挤压综合征患儿用药分析.中国循证医学杂志,2008,8(9):710-712.
6杨造成,彭碧波,白晓东,等.赴巴基斯坦地震医疗救援药品保障的探讨.武警医学,2006,17(2):148-149.
7Roy N,Shah H,Patel V et al.Surgical and psychosocial outcomes in the rural injured-a follow-up study of the2001earthquake victims.Injury,2005,36(8):927-934.
8杨造成,彭碧波,白晓东,等.赴巴基斯坦地震医疗救援药品保障的探讨.武警医学,2006,17(2):148-149.
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