目的：对我院住院患者糖皮质激素药物的使用情况进行分析评价,为规范管理和合理使用提供参考。方法：通过回顾性分析法调取我院2018年1月—2021年12月住院患者糖皮质激素类药物医嘱专项点评结果,采用帕累托分析方法对糖皮质激素类药物不合理情况进行统计分析。结果：360份糖皮质激素专项点评病例中,不合理病例46份,不合理率为12.78%,涉及不合理医嘱47例次。存在糖皮质激素不合理的科室,主要为眼科、肿瘤内科和血液内科,分别占52.17%（24例）、15.22%（7例）和10.87%（5例）;地塞米松注射液为主要不合理的品种,占比89.36%（42例次）;不合理医嘱类型以给药剂型或给药途径不适宜、用法用量不适宜为主,分别占46.81%（22例次）和29.79%（14例次）。结论：运用帕累托图对我院住院患者糖皮质激素不合理科室、品种、医嘱类型进行分析,能直接发现主要因素,便于进行针对性的干预,提高临床用药的合理性。
Abstract
Objective To analyze and evaluate the usage of glucocorticoids among hospitalized patients in our hospital, providing references for the standardized management and rational use. Methods A retrospective analysis method was employed to review the special evaluation results of glucocorticoid prescriptions for hospitalized patients from January 2018 to December 2021, utilizing pareto analysis to statistically analyze the irrational use of glucocorticoid drugs. Results Among 360 glucocorticoid special evaluation cases, 46 cases were identified as irrational, accounting for an irrationality rate of 12.78%, involving 47 instances of irrational prescriptions. Departments where glucocorticoids were used irrationally included Ophthalmology, Oncology, and Hematology, accounting for 52.17% (24 cases), 15.22% (7 cases), and 10.87% (5 cases), respectively. Sodium phosphate dexamethasone injection was the most used drug irrationally, representing 89.36% (42 instances). The main types of irrational prescriptions were inappropriate drug dosage form or route of administration, and inappropriate usage and dosage, accounting for 46.81% (22 instances) and 29.79% (14 instances), respectively. Conclusion Pareto chart analysis can directly identify the main irrational causes of the usage of glucocorticoids among hospitalized patients in our hospital, including departments, drug varieties and prescriptions, which can facilitate targeted interventions and improve the rationality of clinical use of drugs.
关键词
住院患者 /
糖皮质激素 /
专项点评 /
帕累托分析
Key words
hospitalized patients /
glucocorticoid /
special evaluation /
pareto analysis
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基金
湖南省卫生健康委卫生科研课题“负载印度黄檀单体4MOD的PD-1/SIRPα外泌体构建及其靶向膀胱癌效应研究”（W20243148）; 娄底市中心医院院级青年课题“住院患者糖皮质激素专项点评及帕累托分析”（Y2022-12）
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