| 摘要: |
| 目的：了解我院儿科急诊雾化吸入型糖皮质激素用药情况，为临床合理用药提供参考。方法：从我院2017年6-11月的儿科急诊处方中，每月随机抽取雾化吸入处方3 000张，根据就诊卡号筛除同一患儿连续多日用药的重复处方，得到6 327张处方，选取其中应用雾化吸入型糖皮质激素的处方5 881张（93.0%），对处方患儿年龄、药品名称、用法用量、联合用药、临床诊断进行统计分析。结果：5 881张处方中，使用吸入用布地奈德混悬液的处方4 133张（70.3%），吸入用丙酸倍氯米松混悬液的处方1 748张（29.7%）；雾化吸入型糖皮质激素主要应用于6岁以下患儿（75.2%），但未见用于新生儿；单用糖皮质激素雾化的处方仅72张（1.2%），二联用药处方3 442张（58.5%），三联用药处方2 367张（40.3%）；明确使用吸入型糖皮质激素治疗哮喘或支气管哮喘的处方682张（11.6%），超说明书适应证用药处方5 199张（88.4%）。结论：我院儿科急诊雾化吸入糖皮质激素广泛应用于治疗小儿呼吸系统疾病，联合用药普通存在，用药符合治疗指南。超适应证用药普遍存在，有循证医学证据支持，属于合理超说明书用药，但亦存在小部分（6.6%）不合理超说明书用药情况。 |
| 关键词: 儿科 雾化吸入 糖皮质激素 用药分析 |
| DOI：doi:10.13407/ j.cnki.jpp.1672-108X.2019.05.012 |
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| 基金项目: |
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| Prescriptions for Aerosolized Inhalation of Glucocorticoid in Emergency Pediatrics in Our Hospital |
| Hu Xue, Zhang Yueming, Chen Qiuran, Liu Xin |
| (The First Hospital of Jilin University, Jilin Changchun 130021, China)) |
| Abstract: |
| Objective: To investigate the application status of aerosolized inhalation of glucocorticoid in emergency pediatrics prescriptions in our hospital, so as to provide reference for the rational drug application in clinic. Methods: From the emergency pediatrics of our hospital from Jun. to Nov. 2017, there were 3, 000 prescriptions for aerosolized inhalation of glucocorticoid were randomly selected for each month, and totally 18, 000 prescriptions were extracted. Meanwhile, 6, 327 prescriptions were obtained by screening the repeated prescriptions of the same child for multi day medication according to the number of medical cards. A total of 5, 881 prescriptions (93.0%) of aerosolized inhalation of glucocorticoid were selected, and the patients’ age, drug name, usage and dosage, drug combination and clinical diagnosis were statistically analyzed. Results: Of the 5, 881 prescriptions, 4, 133 prescriptions (70.3%) were prescribed for inhalation of budesonide suspension, and 1, 748 prescriptions (29.7%) were prescribed for inhalation of beclomethasone propionate suspension. Aerosolized inhalation of glucocorticoid were mainly used in children under 6 years old (75.2%), yet not in neonates. The prescriptions for aerosolized inhalation of glucocorticoid alone were only 72 (1.2%), the prescriptions for dual therapy were 3, 442 (58.5%), and the prescriptions for triple therapy were 2, 367 (40.3%). There were 682 prescriptions (11.6%) for the treatment of asthma or bronchial asthma with inhaled corticosteroids, and 5, 199 prescriptions (88.4%) for off-label indications. Conclusion: Aerosolized inhalation of glucocorticoid is widely used in pediatric emergency treatment of pediatric respiratory diseases in our hospital. The combined medication is common, which meets the treatment guidelines. The off-label drug use is widespread, supported by the evidence-based medical evidence, which belongs to the reasonable off-label drug use, but there is a small part (6.6%) of unreasonable off-label drug use. |
| Key words: pediatrics aerosolized inhalation glucocorticoids analysis of medication |
