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目的:对老年住院患者万古霉素应用的现状及安全性进行调查分析,以期为老年患者合理应用该药提供参考资料。方法:监测全国13家医院2012年8月~2013年4月各30例连续病例,统计患者应用万古霉素时血生化值、血药浓度值、不良反应发生情况及合并用药等风险点。结果:共采纳有效病例363例,不良反应报道21例,血药浓度监测134例。用药前后血肌酐值差异无统计学意义(P<0.05),尿素氮值差异有统计学意义(P<0.05)。结论:老年患者使用万古霉素时应注重血药浓度监测,联合应用利尿药需谨慎,药物浓度应严格按说明书要求使用。
Objective: To investigate and analyze the status quo and safety of elderly inpatients vancomycin in order to provide reference materials for rational use of this medicine in elderly patients. Methods: Thirty consecutive cases from 13 hospitals in our country from August 2012 to April 2013 were monitored. The blood biochemical values, blood concentration, adverse reactions and risk factors such as combination therapy of vancomycin were calculated. Results: There were 363 valid cases, 21 cases of adverse reactions and 134 cases of blood concentration monitoring. There was no significant difference in serum creatinine before and after treatment (P <0.05), and the difference was significant (P <0.05). Conclusion: Elderly patients should pay more attention to the monitoring of blood concentration when using vancomycin. The combination of diuretics should be cautious. The drug concentration should be used strictly according to the instructions.