医院麻醉药品管理使用现状以及干预分析.docVIP

医院麻醉药品管理使用现状以及干预分析 　　[摘要]目的 研究?t院麻醉药品管理使用现状和临床干预效果。方法 我院从2013年1月开展癌痛规范化治疗示范病房，在施行开展癌痛规范化治疗1年后，从我院信息管理系统中抽取开展示范病房前后的麻醉处方（各3600张）及癌症镇痛（含辅助镇痛）处方（各1800张），根据世界卫生组织癌痛三阶梯镇痛原则对药品的用药频度进行分析。结果 在癌痛第三阶梯药物中，阿片类的硫酸吗啡缓释片、盐酸吗啡片和盐酸羟考酮缓释片在干预前后均排在前三位，是中重度疼痛、爆发性疼痛及剂量滴定的首选用药。癌痛第二阶梯镇痛药物的消耗量在干预后略有降低，在中度疼痛患者中主张应用小剂量的第三阶梯镇痛药，是导致第二阶梯镇痛药用量降低的直接原因。第一阶梯药物和辅助性镇痛药物在干预后呈上升趋势，干预后辅助性镇痛药阿米替林片与卡马西平片的用量明显增加，临床上辅助性镇痛药与镇痛药联合应用得到了重视。结论 通过建立癌痛规范化示范病房对医院麻醉药品的管理使用现状进行干预，根据世界卫生组织三阶梯镇痛原则进行合理干预，可使癌症患者获益，癌痛规范化治疗的经验可在临床中推广。 　　[关键词]麻醉药品；癌痛规范化治疗；临床干预；药品管理 　　[中图分类号] R971.2 [文献标识码] A [文章编号] 1674-4721（2017）09（b）-0160-03 　　Management and using status and intervention analysis of narcotic drugs in the hospitaland 　　WANG Zhi-rong LIN Chun-lan HUANG Xiao-hong LIN Yan-sheng 　　Department of Pharmacy，Affiliated Zhangzhou Hospital of Fujian Medical University，Fujian Province，Zhangzhou 363000，China 　　[Abstract]Objective To study the management and using status of narcotic drugs in the hospital and the effect of clinical intervention.Methods From January 2013，the demonstration ward of carrying out standardized treatment of cancer pain was established.After one-year standardized treatment，the narcotic prescriptions （each with 3600 prescritions） and analgesic prescriptions （each with 1800 prescriptions） for cancer including adjunctive analgesic before and after carrying out demonstration ward were extracted by information management system in our hospital.According to the principle of three-step pain relief for cancer pain by the World Health Organization，the drug frequency was analyzed.Results In the third step of cancer pain，opiates including Morphine Sulfate Sustained-release Tablets，Morphine Hydrochloride Tablets and Oxycodone Hydrochloride Sustained-release Tablets，before and after the intervention were ranked in the top three，and the preferred medication for moderate to severe pain，explosive pain and dose titration.The consumption of analgesic drugs at the second stage for cancer pain was decreased slightly before a