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目的调查心血管内科使用硝酸酯类静脉剂型的情况并评价其合理性。方法通过临床用药决策支持软件分别抽取2014年2~9月使用硝酸酯类静脉剂型的心血管内科病历;随机抽取符合条件的病历100份,根据《硝酸酯在心血管疾病中规范化应用的专家共识》及《硝酸酯类药物静脉应用建议》,对患者的适应证、静脉用药持续时间、是否与单硝酸异山梨酯缓释片联用等进行统计及合理性评价。结果 2014年2~9月,静脉单硝酸异山梨酯共计使用2 003例次;静脉硝酸异山梨酯共计使用45例次;静脉硝酸甘油共计使用1 092例次。随机抽取100份使用硝酸酯类静脉剂型的病历,79例使用单硝酸异山梨酯静脉剂型,药物选择不合理;3例使用硝酸异山梨酯静脉剂型和38例使用硝酸甘油静脉剂型,药物选择合理。82例与单硝酸异山梨酯缓释片联合使用,联合用药不合理。平均疗程分别为8.5 d和9.5 d,疗程偏长。结论 2014年2~9月,新乡医学院第一附属医院硝酸酯类静脉剂型选择品种不当;静脉剂型联合使用口服缓释剂型不合理;静脉用药疗程无依据,无评估。
Objective To investigate the use of nitrate intravenous dosage forms in cardiovascular medicine and to evaluate its rationality. Methods The medical records of cardiovascular medicine using nitrate intravenous dosage form from February to September 2014 were drawn respectively through clinical medication decision support software. 100 cases of medical records were selected randomly. According to the expert consensus on the standardized application of nitrates in cardiovascular diseases, And “recommendations for the application of intravenous nitrate drugs”, the patient’s indications, duration of intravenous drug use, isosorbide mononitrate sustained-release tablets and other statistical and reasonable evaluation. Results From February to September 2014, isosorbide mononitrate was used in a total of 2,003 cases. Isosorbide dinitrate was used in 45 cases in total. A total of 1092 cases of intravenous nitroglycerin were used. Randomly selected 100 cases of nitrate intravenous medical records, 79 cases of isosorbide mononitrate intravenous dosage forms, the drug selection is not reasonable; 3 cases of isosorbide dinitrate intravenous and 38 cases of intravenous nitroglycerine dosage forms, the drug selection is reasonable . 82 cases with isosorbide mononitrate sustained release tablets combined use of combination therapy unreasonable. The average course of treatment were 8.5 d and 9.5 d, long course of treatment. Conclusions From February to September 2014, the variety of nitrate intravenous dosage forms in the First Affiliated Hospital of Xinxiang Medical College was improperly selected. The combination of intravenous dosage forms and oral sustained release dosage forms was unreasonable. There was no evidence for intravenous drug use and no evaluation.