528例ADR报告及处理措施分析
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篇名: 528例ADR报告及处理措施分析
TITLE:
摘要: 目的:为减少ADR的发生和正确处理ADR提供参考。方法:采用Excel电子表格统计和手工筛选,对2005年10月-2015年12月重庆市某“三甲”医院上报的528例ADR报告进行整理,对发生ADR的患者情况、给药途径与ADR发生时间、涉及药品种类、累及器官/系统及临床表现、处理及转归等进行统计分析。结果:65岁以上患者发生ADR共285例(53.98%);原患疾病中呼吸系统疾病最多见(144例,27.27%);有明确过敏史的124例(23.48%);静脉给药引发ADR最多(428例,81.06%);ADR多发生在用药后1 h内(385例,72.92%);抗感染药物、中药制剂引起的ADR位居第1、2位(分别为211、67例,占39.96%、12.69%);ADR累及器官/系统最常见的依次为皮肤及附件(175例,33.14%)、全身反应(148例,28.03%)和用药部位(63例,11.93%);ADR的处理措施主要是停药且进行对症治疗(285例,53.98%);ADR转归主要为痊愈和好转(509例,96.40%)。结论:临床应对ADR处理的特点和规律进行分析,制订ADR确诊、疑似病例的观察、检查、处理、抢救的临床路径,对有全身反应和呼吸系统、循环系统表现的患者要积极处理。
ABSTRACT: OBJECTIVE: To provide reference for reducing the occurrence of ADR and disposing ADR correctly. METHODS: Using the Excel statistics and manual screening, 528 ADR reports were collected from a third grade class A hospital in Chongqing during Oct. 2005 to Dec. 2015.  Those ADR cases were analyzed statistically in respects of general information of ADR patients, routes of administration and occurence time, types of ADR-inducing drugs, organs/systems involved in ADR and clinical manifestations, disposal and outcomes, etc. RESULTS: A total of 285 cases (53.98%) of ADR occurred in elderly patients aged more than 65. Most of original diseases were respiratory system disease (144 cases, 27.27%). 124 ADR cases occurred in people who had allergic history (23.48%). Most of ADR cases were induced by intravenous administration (428 cases, 81.06%). ADR frequently occurred within 1 h after medication (385 cases, 72.92%). Anti-infective agents (211 cases, 39.96%) and TCM preparations (67 cases, 12.69%) were the top 2 involved drug types. The most common ADR occurred in skin and its appendants (175 cases, 33.14%), followed by general reaction (148 cases, 28.03%) and administration sites (63 cases, 11.93%). The treatment of ADR mainly involved drug withdrawal and symptomatic treatment (285 cases, 53.98%). ADR mainly were cured and recovered (509 cases, 96.40%). CONCLUSIONS: The characteristics and regularity of ADR disposal should be analyzed to formulate clinical pathway for ADR diagnosis, suspected cases observation, examination, disposal and rescue. When the patient has general reaction or respiratory system and circulatory system problems, treatments should be more actively processed.
期刊: 2017年第28卷第17期
作者: 曾钰,金蜀蓉
AUTHORS: ZENG Yu,JIN Shurong
关键字: 药品不良反应;药物监测;处理措施;合理用药
KEYWORDS: ADR; Drug monitoring method; Disposal measures; Rational use of drug
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