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目的评价和分析经综合干预后住院患者质子泵抑制剂(PPIs)临床应用的合理性。方法收集2013年7~12月(干预前)和2015年7~12月(干预后)住院患者消耗的PPIs相关数据,比较干预前后PPIs的使用率、消耗量、用药频度(DDDs)、日均费用(DDDc)等;同时每月随机选取干预前后使用PPIs的病历45份,作为干预前组(270份)和干预后组(270份),比较干预前后2组使用PPIs的合理性。结果干预后和干预前相比,PPIs的用药合理率从36.67%上升至65.19%,P<0.001);PPIs使用率从40.05%降为27.01%,P<0.001);其中使用PPIs患者中PPIs针剂使用率从78.05%降为66.07%,P<0.001);PPIs注射剂消耗量占PPIs总消耗量的比例从53.67%降为43.91%,P<0.001)。干预前后均是DDDc值最小的泮托拉唑肠溶片DDDs值最大,DDDs值位居第二的也均为注射用泮托拉唑,但干预后泮托拉唑钠肠溶片与注射用泮托拉唑的DDDs差值明显增大。结论综合干预促进了该院住院患者PPIs的合理应用,同时PPIs的使用率、消耗量等显著降低,其中以注射剂下降最为明显。
Objective To evaluate and analyze the rationality of clinical application of proton pump inhibitors (PPIs) in hospitalized patients after comprehensive intervention. Methods The data of PPIs consumed in hospitalized patients from July to December 2013 (pre-intervention) and July to December 2015 (post-intervention) were collected. The PPI usage, consumption, frequency of DDDs, (DDDc). At the same time, 45 medical records of PPIs were randomly selected before and after the intervention as the pre-intervention group (270 cases) and the intervention group (270 cases) respectively. The rationality of using PPIs before and after the intervention was compared. Results Compared with before intervention, the reasonable rate of PPIs administration increased from 36.67% to 65.19%, P <0.001), PPIs utilization rate decreased from 40.05% to 27.01% (P <0.001) The use rate decreased from 78.05% to 66.07%, P <0.001). The proportion of PPIs injections to total PPIs consumption dropped from 53.67% to 43.91% (P <0.001). Before and after intervention were the DDDc value of the smallest pantoprazole enteric-coated tablets DDDs maximum value, DDDs value ranked second are also injected with pantoprazole, but after intervention pantoprazole sodium enteric-coated tablets and injection DDT difference of pantoprazole increased significantly. Conclusion The comprehensive intervention promoted the reasonable application of PPIs in inpatients in this hospital. At the same time, the usage rate and consumption of PPIs decreased significantly, especially in the case of injections.