目的 探討蚌埠市第三人民醫(yī)院胃內(nèi)鏡黏膜下剝離術(shù)圍術(shù)期用藥情況,為臨床合理用藥提供參考。方法 選取蚌埠市第三人民醫(yī)院2019年1月-2021年3月開展胃內(nèi)鏡黏膜下剝離術(shù)的所有出院病例,依據(jù)最新的共識、指南建立評價標準對圍術(shù)期用藥進行評價分析。結(jié)果 共抽取63份病例,圍術(shù)期存在抑酸劑、抗菌藥物及止血劑不合理用藥現(xiàn)象,主要不合理用藥問題為抑酸劑用藥時機不適宜(30例,47.6%)、止血劑使用無指征(44例,69.8%)和預(yù)防使用抗菌藥物的時機不適宜(47例,74.6%)。結(jié)論 針對蚌埠市第三人民醫(yī)院胃內(nèi)鏡黏膜下剝離術(shù)圍術(shù)期用藥存在的問題,建議嚴格按照指南合理使用質(zhì)子泵抑制劑,避免止血劑的濫用,抗菌藥物的預(yù)防使用遵循《抗菌藥物臨床應(yīng)用指導原則(2015版)》,嚴格術(shù)中無菌操作,把握預(yù)防使用抗菌藥物的指征及預(yù)防使用的療程,同時加大對臨床內(nèi)鏡下胃黏膜剝離術(shù)圍術(shù)期合理用藥的宣教,以促進臨床合理用藥。

Objective To explore the perioperative medication of gastric endoscopic submucosal dissection in Third People’s Hospital of Bengbu, and to provide reference for clinical rational medication. Methods To select all discharged cases of gastric endoscopic submucosal dissection in Third People’s Hospital of Bengbu from January, 2019 to March, 2021, and establish evaluation criteria to evaluate and analyze perioperative medication according to the latest consensus and guidelines. Results A total of 63 cases were selected, and there were irrational drug use of antacids, antibiotics, and hemostatic agents during perioperative period. The main irrational drug use problems were inappropriate timing of antacids (30 cases, 47.6%), no indication of hemostatic agents (44 cases, 69.8%) and inappropriate timing of prophylactic use of antibiotics (47 cases, 74.6%). Conclusion In view of the problems existing in perioperative medication of gastric endoscopic submucosal dissection in Third People’s Hospital of Bengbu, it is suggested that proton pump inhibitors should be used reasonably in strict accordance with the guidelines to avoid the abuse of hemostatic agents, the prevention and use of antibiotics should follow the guiding principles of clinical application of antibiotics in 2015 edition, strict aseptic operation during operation, grasp the indications and treatment course of prevention and use of antibiotics, and at the same time, strengthen the publicity of perioperative rational medication of gastric endoscopic submucosal dissection to promote rational clinical medication.

R975