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目的:分析抗菌药物致不良反应(ADRs)发生的相关因素与干预策略。方法:采用回顾性分析的方法,分析2009年1月—2013年12月间深圳市龙华新区中心医院抗菌药物所致ADRs患者病历资料、不合理用药种类、ADRs表现形式、ADRs分类以及不合理用药与ADRs的相关性。结果:677例ADRs患者中,抗菌药物ADRs患者544例占80.35%,男性患者的发生率为58.27%高于女性41.73%,<18岁的发生率为55.51%高于其他年龄段;头孢菌素类药物为27.45%高于其他类抗菌药物;头孢菌素类所致ADRs的发生率为56.07%高于其他类抗菌药物;不合理用药原因居前3位的分别是给药时间过长、给药浓度过高和滴速过快,其中给药时间过长所致ADRs发生率为59.38%高于其他不合理给药方式;ADRs居前3位的分别是泌尿系统、消化系统、皮肤及软组织,其中泌尿系统的发生率为61.03%高于其他系统;经Person相关性分析表明,抗菌药物给药时间过长、给药浓度过高、滴速过快、剂量不当均与泌尿系统、心血管系统等各类ADRs呈正相关性。结论:医院抗菌药物致ADRs现象不容乐观,应深入分析其发生原因,从社会层面与医院层面入手,给予针对性干预措施,以减少抗菌药物的ADRs发生。
OBJECTIVE: To analyze the related factors and intervention strategies of antimicrobial-induced adverse reactions (ADRs). Methods: A retrospective analysis was conducted to analyze the medical records, types of irrational drugs, manifestations of ADRs, classification of ADRs, and irrational drug use in patients with ADR induced by antibacterial drugs in Longhua New District Central Hospital from January 2009 to December 2013 Correlation with ADRs. Results: Among 677 ADRs patients, 544 cases of ADRs accounted for 80.35%, male patients was 58.27% higher than female 41.73%, <18 years old was 55.51% higher than other age groups; cephalosporins The incidence of ADRs caused by cephalosporins was 56.07% higher than that of other antibacterials. The reason for the unreasonable use of drugs was that the administration time was too long, Drug overdose and drip rate too fast, of which the administration time is too long, the incidence of ADRs was 59.38% higher than other irrational modes of administration; ADRs in the top three are the urinary system, digestive system, skin and soft tissue , Of which urinary system incidence was 61.03% higher than other systems; Person correlation analysis showed that the antibacterial drug administration time is too long, the drug concentration is too high, drip speed too fast, improper dose with the urinary system, cardiovascular System and other types of ADRs was positively correlated. Conclusion: The anti-bacterial drug-induced ADRs in hospital is not optimistic. The cause of ADRs should be deeply analyzed. From the social and hospital levels, targeted interventions should be given to reduce the occurrence of ADRs.