目的 分析藥師對天津醫(yī)院住院患者靜脈用藥不合理醫(yī)囑的干預(yù)結(jié)果，為臨床的合理用藥提供參考。方法 對天津醫(yī)院2018—2020年攔截的住院患者靜脈藥物不合理醫(yī)囑進(jìn)行統(tǒng)計(jì)分析。結(jié)果 2018—2020年不合理醫(yī)囑854份，占總配置數(shù)量的0.27%；按錯(cuò)誤類型排名前3位分別是溶媒選擇不當(dāng)、給藥頻次錯(cuò)誤、用藥劑量錯(cuò)誤；按藥品類別統(tǒng)計(jì)依次為普通藥品、抗菌藥物、細(xì)胞毒藥物與全靜脈營養(yǎng)藥物；創(chuàng)傷病區(qū)不合理醫(yī)囑數(shù)量最多。在藥師的干預(yù)下，靜脈藥物不合理醫(yī)囑發(fā)生率從2018年的0.305 5%下降至2020年的0.219 5%。結(jié)論 藥師進(jìn)行用藥干預(yù)可有效減少不合理醫(yī)囑，顯著提高天津醫(yī)院靜脈藥物的合理用藥水平。

Objective To analyze the intervention results of pharmacists on unreasonable intravenous drug use in inpatients of Tianjin Hospital, and to provide references for rational drug use in clinic. Methods A statistical analysis was made on unreasonable medical orders for intravenous drugs in hospital patients intercepted from 2018 to 2020. Results There were 854 unreasonable medical orders from 2018 to 2020, accounting for 0.27% of total allocation. According to the type of errors, the top three were the improper selection of solvent, the wrong frequency of administration, and the wrong dosage. According to drug categories, they were general drugs, antibacterial drugs, cytotoxic drugs and total parenteral nutrition drugs. The number of unreasonable medical orders in the trauma ward was the largest. Under the pharmacist, sintervention, the incidence of unreasonable medical orders for intravenous drugs decreased from 0.305 5% in 2018 to 0.219 5% in 2020. Conclusion Drug intervention by pharmacists can effectively reduce unreasonable doctor, sorders and significantly improve the level of rational drug use intravenous drugs.

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