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目的探讨2013—2014年某院肝移植患者术后抗排斥药物的应用情况,了解肝移植患者术后潜在的排斥风险及其各类抗排斥药物在肝移植术中的应用特点,为临床合理应用该类药物提供参考。方法通过医院病历查询系统获得2013—2014年肝移植患者的住院信息,统计各抗排斥药物的用量、金额(零售价)等基本数据,并采用用药频度(DDDs)、限定日费用(DDDc)等指标对该类药物的合理性进行评价。结果 2013—2014年某院肝移植患者术后抗排斥药物应用中钙神经抑制剂类药物和激素类药物所占比例较大,其中钙神经抑制剂他克莫司的用药金额为91 586.88元,占总体金额的36.24%,所占比例最大;激素类药物地塞米松用药金额为30.00元,占总体金额的0.01%,所占比例最小。激素类药物甲泼尼龙琥珀酸钠的DDDs为817,占总体DDDs的45%,所占比例最大;抗体制剂巴利昔单抗的DDDs为4,占总体DDDs的2%,所占比例最小。抗体制剂巴利昔单抗的DDDc为18 675,数目最大;激素类药物地塞米松的DDDc为0.36,数目最小。结论某院肝移植术后患者多存在不同程度的排斥反应,能够根据不同类型的患者、不同程度的排斥反应进行个体化用药,抗排斥类药物应用基本合理。
Objective To investigate the application of postoperative anti-rejection drugs in patients with liver transplantation in a hospital from 2013 to 2014, and to understand the potential postoperative risk of rejection and the application characteristics of various anti-rejection drugs in liver transplantation for liver transplantation. Such drugs provide a reference. Methods The hospitalization information of patients with liver transplantation from 2013 to 2014 was obtained through the hospital medical records inquiry system. The basic data of the amount of anti-rejection drugs and the amount (retail price) were calculated. DDDs, DDDc, And other indicators of the rational evaluation of such drugs. Results In 2013-2014, there was a large proportion of anti-rejection drugs used in patients with liver transplantation in a hospital postoperatively. The dosage of calcineurin inhibitor tacrolimus was 91 586.88 yuan, Accounting for 36.24% of the total amount, accounting for the largest proportion; the amount of steroid drug dexamethasone was 30.00 yuan, accounting for 0.01% of the total amount, accounting for the smallest proportion. DDDs of hormonal drug methylprednisolone sodium succinate was 817, accounting for 45% of the total DDDs, accounting for the largest proportion. The DDDs of the antibody preparation basaliximab was 4, accounting for 2% of the total DDDs, accounting for the smallest proportion. The DDDc of the antibody preparation basiliximab was 18 675, the largest number; the DDDc of the hormone drug dexamethasone was 0.36, the smallest number. Conclusion There are many degrees of rejection after liver transplantation in a hospital. Individualized drugs can be administered according to different types of patients and different degrees of rejection. The application of anti-rejection drugs is reasonable.