Page 118 - 《中国药房》2023年5期

·药师与药学服务·

医疗机构阿片类药物使用剂量两种分析方法比较
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季 文 ，侯锐钢 ，孟志强 ，王 忠 ，王立新 ，武 蓓 ，赵 伟 ，段红珍 ，石 萍 ，胡晓玲（1.山西医科大学第二
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医院药学部，太原 030000；2.山西医科大学第一医院药学部，太原 030000；3.临汾市人民医院药学部，山西 临汾
041000；4.运城市中心医院药学部，山西 运城 044000；5.长治医学院附属和平医院药学部，山西 长治 046000）
中图分类号 R954 文献标志码 A 文章编号 1001-0408（2023）05-0620-05
DOI 10.6039/j.issn.1001-0408.2023.05.20
摘 要 目的 比较两种剂量分析方法在分析综合三级甲等医疗机构阿片类药物使用情况中的异同，为医疗机构阿片类药物管理
提供参考。方法 采用限定日剂量（DDD）与口服吗啡等效当量（OME）两种方法统计山西省 5 家综合三级甲等医疗机构（编号
H1～H5 ）2020年阿片类药物的处方数据，计算阿片类药物用量、年人均用量、患者费用负担排序、不同品种药物用量占比等指标，比
较两种剂量分析方法呈现的指标结果，探索两种评估方法各自的优势应用场景。结果 使用两种方法计算5家样本医疗机构阿片
类药物用量和患者费用负担的排序相同，人均用量的排序不同。以5家医疗机构为总体，两种方法比较各品种阿片类药物用量占
比前4位排序相同，从大到小依次为瑞芬太尼＞舒芬太尼＞羟考酮＞吗啡；瑞芬太尼的占比接近50%。比较各医疗机构内药物用
量占比排序时，除H1医疗机构外，其余医疗机构用两种方法计算的结果排序不同。使用DDD法所得芬太尼的用量占比明显高于
OME法；而使用OME法所得瑞芬太尼的用量占比明显高于DDD法。围术期患者的用量占比均为最高，约50%。使用DDD法所
得H3医疗机构急重症患者和H5医疗机构的住院癌痛患者及其他患者的用量占比高于OME法。使用两种方法计算不同类别患者
的费用负担排序有差异。结论 DDD法可较准确地反映阿片类药物的用量，便于对用量的监测管理；而OME法可更多地反映镇痛
效果以及比较患者的费用负担。
关键词 阿片类药物；口服吗啡当量；限定日剂量；用量占比；合理用药

Comparison of two analysis methods of opioid consumption sum in medical institutions
JI Wen ，HOU Ruigang ，MENG Zhiqiang ，WANG Zhong ，WANG Lixin ，WU Bei ，ZHAO Wei ，DUAN
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Hongzhen ，SHI Ping ，HU Xiaoling（1. Dept. of Pharmacy， Second Hospital of Shanxi Medical University，
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Taiyuan 030000， China；2. Dept. of Pharmacy， First Hospital of Shanxi Medical University， Taiyuan 030000，
China；3. Dept. of Pharmacy， Linfen People’s Hospital， Shanxi Linfen 041000， China；4. Dept. of Pharmacy，
Yuncheng Central Hospital， Shanxi Yuncheng 044000， China；5. Dept. of Pharmacy， Heping Hospital Affiliated
to Changzhi Medical College， Shangxi Changzhi 046000， China）
ABSTRACT OBJECTIVE To compare the similarities and differences of the two methods in analyzing the use of opioids in
third grade class A medical institutions and provide a reference for the management of opioids in medical institutions. METHODS
Two methods， Defined Daily Dose （DDD） and Oral Morphine Equivalent （OME）， were used to count the opioid prescription data
of five comprehensive medical institutions of third grade class A （named H1-H5 ） in Shanxi province in 2020， calculate consumption
sum of opioid， annual per capita consumption sum， patient cost burden and drug consumption sum ratio， compare the index results
presented by the two analysis methods， and explore the application scenarios of the advantages of each of the two evaluation
methods. RESULTS The ranking of consumption sum of opioid and patient cost burden calculated by the two methods was the
same in the five sample medical institutions， but the ranking of per capita consumption sum was different. Taking the 5 medical
institutions as a whole， the top 4 rankings of consumption sum ratio for each species of opioid compared by both methods were the
same， i. e. remifentanil＞sufentanil＞oxycodone＞morphine. The ratio of remifentanil was close to 50%. When comparing the
ranking of consumption sum ratio in each medical institution， the ranking calculated by the two methods was different for those
medical institutions except for H1 medical institutions. The consumption sum ratio of fentanyl calculated by DDD method was
significantly higher than that of OME method； whereas consumption sum ratio of remifentanil calculated by OME method was
significantly higher than that of DDD method. Perioperative
patients had the highest consumption sum ratio， about 50%.
Δ 基金项目 山西省卫生健康委科研课题（No.2019118）
＊ 第一作者 副 主 任 药 师 。 研 究 方 向 ：药 事 管 理 。 E-mail： The consumption sum ratio of critically ill patients in H3
jwsydey@163.com medical institutions and inpatient patients with cancer pain and
# 通信作者 副主任药师。研究方向：医院药学、药物经济学。 other patients in H5 medical institutions calculated by DDD
E-mail：wubei8005@163.com method was significantly higher than that by OME method.

· 620 · China Pharmacy 2023 Vol. 34 No. 5 中国药房 2023年第34卷第5期