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·药物与临床·


          我院肿瘤化疗患者止吐药物使用的合理性分析
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          任丹君 ,张娟利,刘美佑,丁莉坤,樊婷婷,张 迪,王婧雯,文爱东(空军军医大学第一附属医院,西安
          710032)


          中图分类号  R975+.4      文献标志码  A      文章编号  1001-0408(2024)12-1495-05
          DOI  10.6039/j.issn.1001-0408.2024.12.14

          摘  要  目的  为肿瘤化疗患者合理使用止吐药物提供参考。方法  利用医院信息系统收集2022年10月1日-11月30日我院肿
          瘤科、放疗科、妇科、消化科等9个科室使用止吐药物的肿瘤化疗患者资料,统计患者化疗药物和止吐药物的使用情况,并分析止
          吐药物不合理用药情况。结果  共纳入 520 例患者,有 248 例患者(47.69%)使用的化疗药物致吐风险等级为中度,135 例患者
         (25.96%)为高度。520例患者共使用5-羟色胺3受体拮抗剂461例次(73.06%),包括帕洛诺司琼333例次、昂丹司琼106例次、托
          烷司琼15例次、格拉司琼7例次,其中优先使用国采药品及国家基本药物的患者仅148例次(32.10%);使用神经激肽1受体拮抗剂
          共170例次(26.94%),包括福沙匹坦112例次、阿瑞匹坦58例次。162例患者(31.15%)的止吐药物使用不合理;不合理用药类型
          中,以止吐方案不合理最多(22.40%),其次为药物经济性不合理(19.13%)。结论  我院肿瘤患者使用的化疗药物致吐风险等级主
          要为中、高风险,在止吐方案、药物经济性等方面存在不合理情况。建议医生、护士、临床药师及医院相关部门应多团队协作,加强
          止吐药物用药标准化全程监管,根据抗肿瘤药物致吐风险等级合理选择止吐药物,提高对指南的遵循度,以保障患者用药安全、有
          效、经济。
          关键词  止吐药物;致吐风险等级;合理用药;化疗所致恶心呕吐;肿瘤

          Rational analysis of the use of antiemetic drugs in tumor chemotherapy patients in our hospital

          REN Danjun,ZHANG Juanli,LIU Meiyou,DING Likun,FAN Tingting,ZHANG Di,WANG Jingwen,WEN
          Aidong(the First Affiliated Hospital of Air Force Medical University, Xi’an 710032, China)

          ABSTRACT   OBJECTIVE  To  provide  reference  for  the  rational  use  of  antiemetic  drugs  in  tumor  chemotherapy  patients.
          METHODS  The  data  of  tumor  patients  who  were  given  antiemetic  drugs  were  collected  from  9  departments  of  our  hospital  with
          hospital  information  system  from  Oct.  1st  to  Nov.  30th  in  2022,  such  as  oncology  department,  radiotherapy  department,
          gynecology  department,  and  gastroenterology  department.  The  application  of  chemotherapy  drugs  and  the  use  of  antiemetic  drugs
          were  analyzed  statistically,  and  the  irrational  use  of  antiemetic  drugs  was  analyzed.  RESULTS  A  total  of  520  patients  were
          included, involving 248 (47.69%) using chemotherapy drugs with a moderate emetogenic risk level and 135 (25.96%) with a high
          emetogenic  risk  level.  A  total  of  461  cases (73.06%)  of  5-hydroxytryptamine  3-receptor  antagonists  were  used,  including
          palonosetron  in  333  cases,  ondansetron  in  106  cases,  tropisetron  in  15  cases  and  granisetron  in  7  cases,  and  only  148  cases  of
          patients  were  prioritized  for  the  use  of  nationally  procured  medicines  and  national  essential  medicines (32.10%).  Neurokinin-1
          receptor antagonists were used in 170 cases (26.94%), including fosaprepitant in 112 cases and aprepitant in 58 cases. The use of
          antiemetic  drugs  was  unreasonable  in  162  patients (31.15%);  among  the  types  of  irrational  drugs,  the  antiemetic  regimen  was
          unreasonable in the largest number of cases (22.40%), followed by the irrational pharmacoeconomics (19.13%). CONCLUSIONS
          The emetogenic risk levels of chemotherapy drugs used for tumor patients in our hospital are primarily moderate to high, and there
          is  irrational  use  of  antiemetic  regimen  and  pharmacoeconomics.  Clinicians,  nurses,  pharmacists  and  hospital  departments  should
          collaborate  as  multiple  teams  to  strengthen  full  supervision  of  the  standardization  of  antiemetic  drugs,  reasonably  select  antiemetic
                                                             drugs  based  on  emetogenicity  rating,  and  improve  the
             Δ 基金项目 国家自然科学基金项目(No.72074218)                  compliance of doctors with the guidelines to ensure the safety,
             *第一作者 主管药师,硕士。研究方向:临床药学。E-mail:
                                                             effectiveness, and cost-effective of patient medication.
          yaya12_30@126.com
             # 通信作者 主任药师,博士生导师,博士。研究方向:临床药学。                 KEYWORDS     antiemetic  drug;  emetogenicity  rating;  rational
          E-mail:18991397171@163.com                         drug use; chemotherapy-induced nausea and vomiting; tumor


          中国药房  2024年第35卷第12期                                              China Pharmacy  2024 Vol. 35  No. 12    · 1495 ·
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