目的 了解我國兒科臨床口服鐵劑應用現(xiàn)狀及存在問題,為兒童合理應用口服鐵劑提供參考。方法 采用文本分析法和問卷調(diào)查法對全國25個省份、直轄市的48家兒童/婦幼醫(yī)院口服鐵劑兒科使用情況進行調(diào)研。結(jié)果 共收回有效問卷1002份。48家醫(yī)院兒科共有22個口服鐵劑品種,其中第3代口服鐵劑應用最為廣泛,劑型以溶液劑為主。在鐵劑選擇方面,多數(shù)醫(yī)師主要考慮藥品和患兒因素,22.54%的醫(yī)師注重個人用藥習慣。在用量方面,多數(shù)參研者主要參照藥品說明書和本行業(yè)指南/共識,部分參研者依據(jù)成人用量換算(占30.04%)或經(jīng)驗用藥(占23.35%)。超過20%的藥師對用藥療程不太了解。85.52%的藥師和98.17%的醫(yī)師會進行用藥注意事項的交代。77.25%的參研者會積極處理口服鐵劑帶來的不良反應,但對可采取的具體措施了解不夠全面。超過40%的醫(yī)師認為患兒用藥依從性一般或較差,并認為其主要影響因素為鐵劑的不良口味(82.34%)。結(jié)論 目前我國兒科臨床應用的口服鐵劑品種和劑型較為合理,但在應用過程中仍存在無據(jù)可依、醫(yī)務人員認識不足及患兒用藥依從性差等問題。相關(guān)部門和各醫(yī)療機構(gòu)應予以重視并采取措施共同促進口服鐵劑在兒科臨床合理應用。

Objective To investigate the clinical situation and problems of oral iron supplements in pediatrics department of China and to provide reference for rational application of oral iron supplements in children.Methods Text analysis and questionnaire survey were used to investigate the pediatric application of oral iron supplements in 48 children's/maternity and children's hospitals in 25provinces and municipalities of China.Results A total of 1 002 valid questionnaires were collected. There were 22 oral iron supplements in 48 hospitals. Among them, the third generation and solutions were the most widely used. Most physicians prescribed oral iron supplements mainly considering the factors of drugs and children, and 22.54% of physicians would pay attention to their personal medication habits. The prescription dosage of oral iron supplements in pediatrics mainly referred to the usage and dosage labeling for children in the drug insert and the industry guidelines/consensus. The conversion of adult dosage according to the drug label and the empirical medication accounted for 30.04% and 23.35%, respectively. More than 20% of the pharmacists did not know much about the course of medication. 85.52% of pharmacists and 98.17% of physicians would explain the precautions for medication.77.25% of the participants would actively deal with the adverse reactions caused by oral iron supplements. However, there was insufficient understanding of specific measures that can be taken. More than 40% of the physicians thought that the medication compliance of children was general or poor. And the bad taste was considered to be the most important fact(82.34%).Conclusion At present, the varieties and dosage forms of oral iron supplements in pediatric clinical application are relatively reasonable. However,there are still problems such as unsubstantiated medication, insufficient awareness among medical staff and poor medication compliance of children. The relevant departments and medical institutions should pay attention and take measures to promote the rational use of oral iron supplements in pediatrics.

R973

福棠兒童醫(yī)學發(fā)展研究中心藥學專委會課題(FTSCR-2022-01)