| 摘要: |
| 目的：了解某军队医院儿科药品不良反应（ADR）发生的特点与规律，为儿科临床合理用药及促进ADR上报监测工作提供参考。方法：利用军队药品不良反应监测管理系统收集某院儿科2014年1月至2017年12月上报的58例ADR报告，采用回顾性方法分别对患者的性别、年龄、原患疾病与既往不良反应史、药物种类、给药途径和剂型、损害类型及临床表现、发生时间与持续时间、关联性、严重程度、处理及转归等情况进行分析；运用鱼骨图法分析我院ADR发生的主要原因及存在问题。结果：58例儿科药品不良反应的男女比例为1.64:1，28天~1岁年龄段患儿最多（29.31%）；原患疾病以呼吸系统疾病为主（68.96%）；共涉及药物类别19种，以抗菌药物居首（62.07%），其次为中药制剂（15.52%）；给药途径和药品剂型以静脉给药和粉针剂为主；最常见的临床表现为消化道系统损害（49.18%），其次为皮肤及附件损害（34.42%）；发生时间多在给药后24 h以内（58.62%），持续时间以24 h以内为主（82.76%）；新的和严重的ADR有11例（18.96%），全部转归良好；报告者职业均为医师。结论：某院儿科ADR的发生与患儿年龄、原患疾病、药物种类及给药途径等多种因素相关，需加强ADR监测和上报工作，从多方面采取措施防范儿童用药风险，促进儿童合理用药。 |
| 关键词: 儿童 药品不良反应 回顾性分析 鱼骨图分析 |
| DOI：doi:10.13407/ j.cnki.jpp.1672-108X.2019.05.014 |
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| 基金项目: |
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| Retrospective Analysis of Adverse Drug Reactions in Pediatrics of a Military Hospital |
| Jiang Juan, Lin Zhen, Du Jiangtao |
| (No. 174th Hospital of PLA, Fujian Xiamen 361003, China) |
| Abstract: |
| Objective: To investigate the characteristics and regularities of adverse drug reactions (ADR) in pediatrics of a military hospital, so as to provide reference for clinical rational drug use in pediatrics and promote the reporting and monitoring of ADR. Methods: Through the military ADR monitoring system, a total of 58 qualified pediatric ADR reports from Jan. 2014 to Dec. 2017 were collected. Retrospective analysis was conducted on patient’s gender, age, primary disease and history of ADR, drug categories, route of administration and dosage form, damage types and clinical manifestations, occurrence time and duration, relevance evaluation, severity and prognosis, etc. The fishbone diagram method was used to analyze the main causes and existing problems of ADR in our hospital. Results: Among the 58 pediatric ADR cases, the male to female ratio was 1.64:1, and children aged from 28 d to 1 year old were the most (29.31%). The primary disease of children with ADR was mainly the respiratory disease (68.96%). A total of 19 categories of drugs were involved, with antibiotics taking the lead (62.07%), followed by traditional Chinese medicine (15.52%). The route of administration and dosage form were mainly intravenous administration and powder injection. The most common clinical manifestations were digestive system damage (49.18%), followed by skin and its accessory damage (34.42%). The occurrence time of ADR was mostly within 24 h after administration (58.62%), and the duration was mainly within 24 h (82.76%). New and severe ADR reports were 11 cases (18.96%), all of which turned out well. All these ADR were reported by doctors. Conclusion: The occurrence of pediatric ADR is related to a variety of factors, including the age of the children, primary disease, categories of drugs and route of administration. Therefore, it is necessary to strengthen the monitoring and reporting of ADR, take measures from various aspects to prevent the risk of drug use and promote the rational drug use in children. |
| Key words: children adverse drug reaction retrospective analysis fishbone diagram method |
