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目的:调查某三甲医院住院患者药品不良反应(ADR)发生情况。方法:选择该院呼吸、肾内、风湿免疫、消化和内分泌科644名住院患者,由4位临床药师每日问诊,记录患者住院期间使用药物、剂量、给药途径和给药起始时间,严密观察患者不良反应。结果:644名患者中75例在住院期间发生了ADR,其中胃肠道(26.7%)、神经系统(24.0%)和皮肤系统(18.7%)是主要受累器官。抗感染药ADR所占比例最高(40.0%),其次为心血管药物(12.0%)和中药注射剂(10.7%)。用药品种繁多是发生ADR因素之一(P=0.001),而ADR与性别、诊断数目及住院天数无关。75例ADR患者中的40例(53.3%)处理ADR产生了额外费用,最低费用0.36元,最高费用4158元,平均258.4元。结论:住院期间发生ADR,对患者健康和经济有较大影响。抗感染药和中药ADR是关注重点。同时使用多种药物是ADR发生的重要因素之一。
Objective: To investigate the incidence of adverse drug reactions (ADR) in hospitalized patients in a top three hospital. Methods: A total of 644 inpatients with respiratory, intrarenal, rheumatoid, digestive and endocrinology were enrolled in the study. Four clinical pharmacists interviewed daily to record the patients’ medication, dosage, route of administration and administration start time , Closely observe the adverse reactions in patients. Results: Of the 644 patients, 75 developed ADR during hospitalization, with gastrointestinal (26.7%), nervous system (24.0%) and cutaneous system (18.7%) being the major affected organs. The highest proportion of anti-infectives ADR (40.0%), followed by cardiovascular drugs (12.0%) and Chinese medicine injection (10.7%). Variety of drugs is one of the factors that cause ADR (P = 0.001), and ADR has nothing to do with sex, number of diagnosis and days of hospitalization. Forty patients (53.3%) of 75 ADR patients had additional costs for ADR treatment, with a minimum cost of 0.36 yuan and a maximum cost of 4158 yuan, an average of 258.4 yuan. CONCLUSIONS: ADR during hospitalization has a greater impact on patient health and economy. Anti-infectives and traditional Chinese medicine ADR is the focus of attention. The use of multiple drugs at the same time is one of the important factors of ADR.