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目的 :通过病历调查脑梗死患者药物治疗情况 ,探讨其合理性 ,供进一步研究该病治疗方案作参考。方法 :以随意抽样方式收集武汉市 15家医院 140例初次发生脑梗死病历 ,统计分析用药情况。结果 :本组病例大都采用以脱水药、溶栓药、抗血小板改善脑循环、营养脑细胞、支持疗法为主的中西医结合疗法。其中使用频度高的药物包括甘露醇 86例次 (86 / 140 ) (6 1.4% ) ,溶栓药 5 9例次 (5 9/ 140 ) (42 .1% ) ,抗血小板、改进脑循环的各种中西药计 396例次 (396 / 140 ) ,平均每例用此类药 2 .8种 ,保护脑细胞药 12 4例次 (12 4/ 140 ) (88.6 % )。治疗并发及合并症药中抗感染药使用 75例次 (75 / 140 ) 5 3 .5 % ,除去联用者 ,实际应用为 5 3例 (5 3/ 140 ) (37.9% ) ,其中治疗及抢救用 30例 (30 / 5 3) (5 6 .6 % ) ,治疗合并症及并发症频率高者依次为降压药 83例次 (83/ 140 ) (5 9.2 % ) ,治心脏病药 84例次 (84/ 140 ) (6 0 .0 % ) ,降糖药 31例次 (31/ 140 ) (2 2 .1% ) ,降脂药 2 1例次 (2 1/ 140 ) (15 .0 % )。资料中 140例临床治愈及好转率为 90 .7% ,死亡率 2 .9% ,病未愈自动出院 9例 (6 .4% ) ,说明用药基本合理。存在问题 :某些药使用有偏滥之虞 ,如保护脑细胞药占总例次的 88.6 % ,该类药物价格
Objective: To investigate the drug treatment of patients with cerebral infarction through medical records and to explore its rationality for further study of the treatment plan of the disease. Methods: 140 cases of primary cerebral infarction medical records were collected from 15 hospitals in Wuhan by random sampling, and the status of medication was analyzed statistically. Results: Most of the patients in this group were treated with dehydration drugs, thrombolysis drugs, anti-platelet therapy to improve cerebral circulation, nutritional brain cells, and supportive therapy. Among them, the frequently used drugs included mannitol 86 cases (86/140) (6 1.4%), thrombolytic drugs 59 cases (5 9/140) (42.1%), antiplatelet, and improved cerebral circulation. A total of 396 cases of Chinese and Western medicines (396/140) were used, with an average of 2.8 kinds of such drugs in each case, and 12 4 cases of protective brain cells (12 4/140) (88.6 %). The use of anti-infective drugs in the treatment of concurrent and comorbid drugs was 75 times (75/140), 53.5%, except for the combined use. The actual application was 53 cases (5 3/140) (37.9%), including treatment and Thirty patients (30/53) (56.6%) were rescued. The highest frequency of complications and complications were 83 cases (83/140) (59.2%) of antihypertensive drugs. 84 cases (84/140) (60%), hypoglycemic agents 31 times (31/140) (22.1%), lipid-lowering drugs 21 cases (2 1/140) (15 .0 % ). In the data, 140 cases had a clinical cure and improvement rate of 90.7%, a mortality rate of 2.9%, and 9 cases (6.4%) were discharged from the hospital. This shows that the medication is basically reasonable. There is a problem: Some medicines have been abused, such as the protection of brain cells accounted for 88.6 % of the total number of cases, the price of such drugs