目的 調(diào)查并分析天津市第一中心醫(yī)院蛇毒血凝酶的臨床真實(shí)應(yīng)用情況及規(guī)律，為指導(dǎo)臨床安全、合理用藥提供參考。方法 回顧性分析2022年1～8月天津市第一中心醫(yī)院使用蛇毒血凝酶的住院患者病歷信息，統(tǒng)計患者性別、年齡、臨床診斷、用藥情況、療程＞5 d、是否監(jiān)測纖維蛋白原（FIB）水平及藥物不良反應(yīng)（ADRs）等相關(guān)信息，依據(jù)藥品說明書及相關(guān)共識，評價用藥合理性。結(jié)果 22個臨床科室共1 170例患者使用了蛇毒血凝酶，使用量前3位的科室為神經(jīng)外科、肝膽外科及耳鼻喉科；622例患者（占53.16%）為預(yù)防性用藥，548例（占46.84%）為治療性用藥；給藥途徑以iv為主；共有578例次不合理用藥，存在的主要問題為未監(jiān)測FIB、療程過長以及給藥途徑不合理等；總ADRs發(fā)生率為1.54%，發(fā)生FIB降低的ADRs共有18例，無過敏反應(yīng)的ADRs。結(jié)論 天津市第一中心醫(yī)院臨床使用蛇毒血凝酶的比例高，但仍存在較多不合理用藥情況，臨床應(yīng)嚴(yán)格按照藥品說明書或共識使用并監(jiān)測凝血指標(biāo)，避免療程過長，以減少ADR，并增加用藥安全性。

Objective To explore the clinical application and rational evaluation of hemocoagulase in Tianjin First Central Hospital to provide references for rational drug use. Methods Medical records of hospitalized patients using hemocoagulase in Tianjin First Central Hospital from January to August 2022 were retrospectively analyzed, and relevant information such as gender, age, clinical diagnosis, medication status, duration of treatment > 5 d, whether fibrinogen (FIB) level was monitored, and adverse drug reactions (ADRs) were collected. Evaluate the rationality of drug use. Results A total of 1 170 patients in 22 clinical departments were treated with hemagglutinin, and the top 3 departments were neurosurgery, hepatobiliary surgery, and otolaryngology. 622 Patients (53.16%) used prophylactic drugs, and 548 patients (46.84%) used therapeutic drugs. The main route of administration was intravenous injection. There were 578 cases of irrational drug use, and the main problems were not monitoring FIB, too long course of treatment, and unreasonable route of drug administration. The total incidence of ADRs was 1.54%, and there were 18 cases of ADRs with reduced FIB, and no ADRs with allergic reaction. Conclusion The proportion of clinical use of hemagglutinin is high, but there are still many irrational drug use cases. Clinical use should be strictly in accordance with drug instructions or consensus, and coagulation indexes should be monitored to avoid too long course of treatment, so as to reduce ADR and increase drug safety.

R973

北京慢性病防治與健康教育研究會糖尿病防治及管理研究項(xiàng)目專項(xiàng)課題（MBZX0022023-004）；吳階平醫(yī)學(xué)基金會臨床科研專項(xiàng)資助基金（320.6750.2020-11-32）