摘要
目的：统计分析本院中西药不合理联用127例，总结对策，促进合理用药。方法：采用回顾性的分析方法，利用医院计算机病案系统调取不合理用药病历资料，对不合理用药的原因、分布等资料进行统计分析，统计发生不良反应例次。结果：中西药不合理联用127例，发生率7.43%，不合理类型中由多到少依次为药理拮抗性联用51例（40.16%）、理化禁忌联用46例（36.22%）、发药源性疾病联用13例（10.24%），用量过多11例（8.66%）、重复给药6例（4.72%）。不合理用药门诊103例（81.10%），住院部24例（18.90%）。不良反应63例，其中理化禁忌联用发生40例，发生率86.96%；药理拮抗性联用发生20例，发生率39.22%；发药源性疾病联用发生2例，发生率15.38%；用量过多发生1例，发生率9.09%。非处方药18例占14.17%，处方药109例占85.83%；药师参与19例占14.96%；个案发生35例占27.56%；本科及以上学历开据不合理中西药联合方案发生率4.94%明显低于本科以下者的10.01%，差异有统计学意义（P〈0.05）；工龄在5年以下者开据联合方案不合理发生率17.43%均明显高于工龄5~10年的5.52%和＆gt;10年者的6.06%，差异均有统计学意义（P〈0.05）。结论：中西药不合理联用现象较普遍，并引发了较多不良反应，主要集中在门诊、非处方药、未有药师参与者，且多非个案；医院应该加强有关培训，提高医师综合素质，建立健全药房管理制度，积极总结工作经验；提高对门诊、非处方药的重视力度，严格把关。
Objective：To statistical analysis of 127 cases of Chinese and western medicine unreasonable combination in our hospital,summarize the countermeasure and promote rational drug use.Method：A retrospective analysis method was adopted,the irrational drug use medical records were obtained using the hospital computer medical record system,reason of irrational use of antibiotics,the distribution of data were analyzed,adverse reaction cases were counted.Result：127 cases of Chinese and western medicine unreasonable combination,the incidence rate was 7.43%.Unreasonable types from more to less followed by pharmacological antagonist combination with 51 cases（40.16%）,the physical and chemical taboo combination with 46 cases（36.22%）,medicine source disease combination with 13 cases（10.24%）,the excessive amount of 11 cases （8.66%）,repeated administration of 6 cases（4.72%）.The irrational drug use of outpatient in 103 cases（81.10%）,24 cases of inpatient department（18.90%）.63 cases of adverse reactions,including physical and chemical with the taboo occurred in 40 cases,the incidence rate was 86.96%;pharmacological antagonistic combination in 20 cases,the incidence rate was 39.22%,with medicine source disease occurred in 2 cases,the incidence rate was 15.38%;excessive dosage occurred in 1 case,the incidence rate was 9.09%.18 cases of over-the-counter medications（14.17%）,prescription drugs in 109 cases （85.83%）,pharmacists participated in 19 cases（14.96%）,case happened 35 cases（27.56%）. The Chinese and western medicine combined unreasonable schemes of bachelor degree or above was 43 cases,the incidence rate was 4.94%,it was significantly lower than the undergraduate below（10.01%）,the difference was statistically significant（P〈0.05）.The Chinese and western medicine combined unreasonable schemes of less than 5 years length of service,the incidence rate was 17.43%,it was significantly higher than length of service 5-10 years（5.52%）and＆gt;10 years（6.06%）,the differences were statistically significant（P〈0.05）.Conclusion：The unreasonable phenomenon of Chinese and western medicine is relatively common,and trigger a more adverse reactions,mainly concentrate in the outpatient service,over-the-counter medications,no pharmacists participants and not the case.Hospital should strengthen the related training,improve the overall quality,establish and improve the pharmacy management system,and actively summarize experience.Increase efforts to the attention of the outpatient service, over-the-counter medications,strictly controlled.
出处
《中国医学创新》
CAS
2014年第10期123-125,共3页
Medical Innovation of China
关键词
中西药
联合应用
非处方药
Chinese and western medicine
Joint application
Over-the-counter drugs
