CAJ | 학술논문

目的分析中国医科大学附属第一、第二、笫四医院2005年7月至2006年7月急诊镇痛药使用情况,旨在为临床合理用药提供有益参考.方法对1年中资料完整的急诊镇痛药处方2312张进行描述性分析,项目包括处方的一般情况、药品的使用病因及频度、麻醉药品的用药频率(DDDs)以及药物利用指数(DUI),其中200例患者接受治疗效果的问卷调查.调查以进入和离开急诊作为时间点.疼痛程度评估采用0～10数字量表(NRS).患者对镇痛效果满意程度进行选择.未选人聋哑者、囚犯、家庭暴力受害者及精神异常者,亦不包括14岁以下的患者.分类资料统计发生率和构成比,治疗前后疼痛评分采用配对t检验.结果镇痛药以注射液剂型为主,山莨菪碱和布桂嗪注射液应用最多,口服片剂较少.外伤痛是最多应用镇痛药的病因.麻醉性镇痛药中,DDDs及DUI均小于世界卫生组织限定值.哌替啶注射液应用最多.接受调查的患者中,71.5%对治疗的效果满意或基本满意;用药前NRS评分7.47±2.21,用药后评分5.00±3.16,评分显著降低(统计量t值23.38,P<0.01);但评分4分及4分以上患者仍占57.5%.结论三所医院急诊能对疼痛患者进行初步处理.麻醉性镇痛药的使用较为谨慎.急诊镇痛效果仍有待进一步提高.
목적 분석중국의과대학부속제일、제이、자사의원2005년7월지2006년7월급진진통약사용정황,지재위림상합리용약제공유익삼고.방법 대1년중자료완정적급진진통약처방2312장진행묘술성분석,항목포괄처방적일반정황、약품적사용병인급빈도、마취약품적용약빈솔(DDDs)이급약물이용지수(DUI),기중200례환자접수치료효과적문권조사.조사이진입화리개급진작위시간점.동통정도평고채용0～10수자량표(NRS).환자대진통효과만의정도진행선택.미선인롱아자、수범、가정폭력수해자급정신이상자,역불포괄14세이하적환자.분류자료통계발생솔화구성비,치료전후동통평분채용배대t검험.결과 진통약이주사액제형위주,산랑탕감화포계진주사액응용최다,구복편제교소.외상통시최다응용진통약적병인.마취성진통약중,DDDs급DUI균소우세계위생조직한정치.고체정주사액응용최다.접수조사적환자중,71.5%대치료적효과만의혹기본만의;용약전NRS평분7.47±2.21,용약후평분5.00±3.16,평분현저강저(통계량t치23.38,P<0.01);단평분4분급4분이상환자잉점57.5%.결론 삼소의원급진능대동통환자진행초보처리.마취성진통약적사용교위근신.급진진통효과잉유대진일보제고.
Objective To analyze analgesics administration from July 2005 to July 2006 in emergency rooms of the First, the Second and Fourth Affiliated Hospitals of China Medical University in order to provide a reference for clinically rational administration. Method The data of 2313 prescriptions with analgesics administered during one-year period were analyzed in many respects including the overview of the prescriptions, the frequency of anal-gesics administration, the system of defined daily doses (DDDs) and drug utilization index (DUI) of narcotic anal-gesics were analyzed, and a survey of 200 patients managed with some of those analgesics was done by using ques-tionaire as they were admitted to and discharged from the emergency room. The pain intensity was evaluated by a 10-point numerical rating scale (NRS). The respondents, excluding the mute or deaf, police custody, victims of domestic violence,mental disorder and age under 14,rated the levels of satisfaction with medication for pain relief. The data of frequency and percentage of the administration of analgeics were analyzed,and the scores of NRS were evaluated with the Paired-samples t -test. Results Most of analgesics were in the form of parenteral route usage, of which anisodamine and bucinnazine were employed in large proportion, and a small number of them was in the form of tablets. Trauma was the commonest cause of pain. Of the narcotic analgesics, meperidine was the most com-monly used analgesics, and its DDDs and DUI were much lower than that of WHO limits. Of the 200 patients, 71.5% patients rated a considerably high satisfaction with scores of (7.47 ±2.21) and (5.00 ± 3. 16) by NRS before and after medication,respectively ( ( -value 23.38,P < 0.01) .The patients presenting pain intensity with a scores of 4 or greater accounted for 57.5% . Conclusions The patients suffering from pain could lie rationally treated in the emergency rooms of those three hospitals. Narcotic analgesics should be cautiously employed, and there is room for improvement in pain management practice in emergency room.