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目的探讨笔者所在医院儿童药品不良反应(adverse drug reaction,ADR)监测工作中存在的问题及改进措施。方法采用回顾性分析法,对笔者所在医院2010—2011年上报的305例ADR报告,按照报告类型,患儿年龄、性别、体重,药品种类、给药途径,临床表现等方面进行统计分析。结果 305例ADR报告中,患儿的平均年龄为(3.16±2.91)岁,平均体质量为(14.56±8.00)kg,男女比例为1.88∶1,0～3岁患儿占53.44%;新的和严重的ADR占16.39%;引发ADR最多的是抗微生物药,占75.30%;最主要的给药方式是静脉滴注,占95.08%;ADR累及器官或系统中皮肤及其附件与消化系统占80.24%;严重的ADR中46.67%发生在用药4 d后。结论为做好儿童ADR监测工作,医院必须增加必要的设施,制定切实可行的管理办法,强化科室内部管理,加强培训,提高医师和护士上报ADR的积极性,改变医师的用药习惯,增强医师和护士对儿童心理及行为的了解。
Objective To explore the problems existing in the monitoring of adverse drug reaction (ADR) in the hospital where the author is located and the remedies. Methods A retrospective analysis was used to analyze 305 ADR cases reported by the author’s hospital from 2010 to 2011 according to the report type, age, sex, weight, type of drug, route of administration and clinical manifestation. Results The average age of children in the 305 ADR cases was (3.16 ± 2.91) years old, the average body weight was (14.56 ± 8.00) kg, the male-female ratio was 1.88:1, and the children aged 0-3 years accounted for 53.44%. The new And ADR accounted for 16.39%. The most common cause of ADR was antimicrobials, accounting for 75.30%. The most important mode of administration was intravenous drip, accounting for 95.08%. ADR involved the skin and its accessories and digestive system in organs or systems 80.24%; 46.67% of severe ADR occurred after 4 days of treatment. Conclusion In order to do a good job of ADR monitoring in children, the hospital must increase the necessary facilities, formulate practical management methods, strengthen departmental internal management, strengthen training, improve the motivation of physicians and nurses to report to ADR, change physicians’ medication habits and enhance doctors and nurses Understanding of children’s psychology and behavior.