Page 21 - 《中国药房》2022年23期

8家“三甲”儿童/妇幼医院门急诊口服铁剂处方调研 Δ

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李荣荣 ，刘 倩，王婷谕，孙燕燕（天津市儿童医院/天津大学儿童医院药剂科，天津 300134）
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中图分类号 R952 文献标志码 A 文章编号 1001-0408（2022）23-2831-05
DOI 10.6039/j.issn.1001-0408.2022.23.03

摘 要 目的 了解我国儿科临床口服铁剂的应用现状及存在的问题，为儿童口服铁剂的合理应用提供参考。方法 通过调研全
国六大行政区域内8家“三甲”儿童/妇幼医院2021年1－6月含口服铁剂的全部门急诊处方（儿童患者），对处方中涉及的患儿基本
信息、口服铁剂品种、联合用药情况、临床诊断、超说明书用药情况等进行统计分析。结果 本研究共调研门急诊处方20 988张，涉
及12种口服铁剂。其中，第3代口服铁剂处方数（14 038张，占66.89%）最多，剂型以口服溶液剂为主；年龄范围在1～＜3岁患儿
的处方数（8 532张，占40.65%）最多；处方中与口服铁剂联用的药物多为维生素类（5 577张，占26.57%）；临床诊断为铁缺乏/缺铁
性贫血以外其他疾病或症状的处方超过一半（11 210张，占53.41%）；超说明书用药处方共13 615张（占64.87%），主要为超适应证
用药（10 923张，占52.04%）和超用法用量用药（6 393张，占30.46%）；禁忌证用药处方共163张（占0.78%）。结论 我国“三甲”儿
童/妇幼医院儿科临床中口服铁剂品种和剂型的选择较为合理，但超说明书用药问题仍有待解决。相关部门和各医疗机构应予以
重视并采取措施共同促进口服铁剂在儿科临床合理应用。
关键词 口服铁剂；儿童；超说明书用药；处方分析

Investigation of the prescriptions of outpatient/emergency oral iron supplements in 8 children’s/maternity
and children’s hospitals of third-grade class A
LI Rongrong，LIU Qian，WANG Tingyu，SUN Yanyan（Dept. of Pharmacy， Tianjin Children’s Hospital/Tianjin
University Children’s Hospital， Tianjin 300134， China）

ABSTRACT OBJECTIVE To investigate clinical situation and problems of oral iron supplements in pediatrics department of
China， and to provide reference for rational application of oral iron supplements in children. METHODS Through surveying the
prescriptions of outpatient/emergency oral iron supplements （pediatric patients） in 8 children’s/maternity and children’s hospitals of
third-grade class A from six administrative regions of China， the information of the prescriptions was analyzed statistically in terms
of general information of children， the types of oral iron supplements， drug combination， clinical diagnosis， off-label drug use.
RESULTS A total of 20 988 outpatient/emergency prescriptions were investigated， involving 12 kinds of oral iron supplements.
Among them， the third generation of oral iron supplements ranked first（14 038 prescriptions，66.89%）， and the dosage form was
mainly oral solution. Children aged 1-＜3 years old accounted for the largest proportion（8 532 prescriptions，40.65%）. Most of the
drugs prescribed in combination with oral iron supplements were vitamins（5 577 prescriptions，26.57%）. More than half of the
prescriptions（11 210 prescriptions，53.41%） were for diseases or symptoms other than iron deficiency/iron deficiency anemia. There
were a total of 13 615 prescriptions（64.87%） of off-label drug use， mainly manifesting as super-indications （10 923 prescriptions，
52.04%） and super-usage and dosage（6 393 prescriptions，30.46%）. There were 163 prescriptions beyond contraindications （0.78%）.
CONCLUSIONS The varieties and dosage forms of oral iron supplements in pediatrics are comparatively reasonable in children’s/
maternity and children’s hospitals of third-grade class A in China，but the problem of off-label drug use still needs to be solved. The
relevant departments and medical institutions should pay attention and take measures to promote the rational use of oral iron
supplements in pediatrics.
KEYWORDS oral iron supplements； children； off-label drug use； prescription analysis

铁缺乏（iron deficiency，ID）和缺铁性贫血（iron- 健康的营养性疾病。2008年全球数据显示，我国学龄前
[1]
deficiency anemia，IDA）是儿童期最为常见且严重威胁 儿童 IDA 患病率为 20%～39.9% 。研究显示，2016－
2020年我国儿童IDA 患病率降至16.8%，但婴幼儿及部
Δ 基金项目 福棠儿童医学发展研究中心药学专业委员会课题 分地区儿童IDA患病率仍较高 。口服补铁是控制和降
[2]
（No.FTSCR-2022-01）
低儿童 ID 和 IDA 患病率的主要措施，但口服铁剂种类
＊第一作者 主管药师，硕士。研究方向：儿科临床药学。电话：
022-87787242。E-mail：lirongronghh@163.com 较多，部分口服铁剂缺少儿童临床试验数据和用药信
息，且口服铁剂在儿科临床中的规范用药和处方审核均
# 通信作者 主任药师，硕士生导师，硕士。研究方向：药事管理。
电话：022-87787305。E-mail：syytjcn@sina.com 缺乏权威依据。为全面了解我国儿科临床口服铁剂的

中国药房 2022年第33卷第23期 China Pharmacy 2022 Vol. 33 No. 23 · 2831 ·