某院围术期预防应用质子泵抑制剂合理性及成本-效果分析OA

Objective To investigate the current situation of perioperative prophylactic use of proton pump inhibitors(PPIs)in a hospital,analyze the rationality of its use,explore the cost-effectiveness of different drug regimens,and evaluate the pharmacoeconomics.Methods The archival medical records of the surgical department of Karamay Hospital of Integrated Chinese and Western Medicine from January to December 2022 were selected to screen perioperative prophylactic application of PPIs,summarize the use situation and evaluate the rationality of drug use.Groups A,B and C were divided into three groups according to drug selection.Group A was prophylaxis with omeprazole sodium for injection,group B was prophylaxis with lansoprazole sodium for injection,and group C was prophylaxis with Pantoprazole sodium for injection.The incidence of prevention of stress ulcer(SU),incidence of adverse drug reactions and cost-effectiveness of different PPIs were compared.Results A total of 387 medical records were used for perioperative prophylactic use of PPIs,including 272 patients with indications and 115 patients with drugs without reference.There was no significant difference in the incidence of SU,the incidence of adverse drug reactions and the effective rate of SU prevention among 3 groups(P＞0.05).In group A,B and C,the C/E of group A was the lowest,followed by group C,and group B was the highest.Compared with group A,the cost of prophylactic PPIs in group B increased by 14.72 yuan for every 1 unit increase in efficacy.In group C,the cost of prophylactic PPIs increased by 6.96 yuan for each additional unit of efficacy.Conclusion The prophylactic application of PPIs during perioperative period in our hospital is unreasonable,and corresponding measures should be taken to improve it.Omeprazole is an effective and economical scheme to prevent SU.