摘要
目的临床药师根据最新ICU应激性溃疡预防(SUP)指南建立ICU-SUP的药学干预模式,评估干预模式对重症患者SUP合理用药的影响。方法选取2022—2023年宣武医院收治的ICU患者,根据ICU住院日期分为对照组(2022年1—12月)和干预组(2023年1—12月),比较临床药师推进实施预防应激性溃疡药学干预效果。结果共纳入459例患者,干预组239例,2469个患者日;对照组220例,2353个患者日。干预后,患者日用药合理率提高了15.0%,日过度用药比例降低了7.2%,日用药不足比例下降了4.5%。隐性出血发生率显著降低,患者肺炎、难辨梭菌感染、ICU住院时间无明显变化(P>0.05)。结论ICU-SUP药学干预模式在SUP中取得初步成效,减少了出血发生率。
Objective To establish a pharmaceutical intervention mode for the stress ulcer prophylaxis(SUP)in ICU according to the latest ICU-SUP guidelines and evaluate the effect of the intervention mode on rational drug use for SUP in critically ill patients.Methods Patients admitted to the ICU of Xuanwu Hospital from 2022 to 2023 were selected.They were divided into the control group(from January to December 2022)and the intervention group(from January to December 2023)based on the date of ICU admission.The effectiveness of pharmacological intervention for preventing stress ulcers promoted by clinical pharmacists was evaluated.Results A total of 459 patients were included,with 239(2469 patient-days)in the intervention group and 220(2353 patient-days)in the control group.After the intervention,the rate of rational drug use patient-days increased by 15.0%,the proportion of medication overuse patient-days decreased by 7.2%,and the proportion of insufficient medication patient-days decreased by 4.5%.The incidence of occult bleeding significantly decreased,while the incidences of pneumonia,Clostridium difficile infection,and the length of ICU stay did not show significant changes(P>0.05).Conclusion The ICU-SUP pharmacological intervention mode has achieved preliminary effect in the SUP process and has reduced the incidence of bleeding.
作者
杨欢
张兰
徐忆纯
苏甦
沈江华
刘宇雁
褚燕琦
YANG Huan;ZHANG Lan;XU Yichun;SU Su;SHEN Jianghua;LIU Yuyan;CHU Yanqi(Department of Pharmacy,Xuanwu Hospital Capital Medical University,Beijing 100053,China;Department of Pharmacy,Liupanshui Maternal and Child Health Hospital(Liupanshui Children's Hospital),Liupanshui,Guizhou Province 553000,China;Department of Critical Care Medicine,Xuanwu Hospital Capital Medical University,Beijing 100053,China)
出处
《临床药物治疗杂志》
2025年第7期83-89,共7页
Clinical Medication Journal
关键词
预防应激性溃疡
合理用药
重症患者
药学干预
stress ulcer prophylaxis
rational drug use
critically ill patients
pharmaceutical intervention
