目的 通过处方自动筛选系统对处方进行点评分析,提高医院合理用药水平。方法 利用处方自动筛选系统,采取等距离抽样法,按月份抽取武警四川总队成都医院2013-01-01至2013-12-31门诊、急诊处方共1800张。根据点评内容和点评依据对处方进行点评分析。结果 所筛选的处方中平均每张处方开具药品2.50个,抗菌药物使用率为31.41%,注射剂使用率为23.21%,使用通用名的比例为76.33%,人均处方金额178.39元,处方合理用药率为95.53%。不合理处方81张,不规范处方占38.27%,用药不适宜处方占55.56%,超常处方占6.17%。典型的不合理处方主要有:处方未写临床诊断或诊断书写不规范、头孢克肟用于上感患者、拔牙患者阿莫西林与罗红霉素联用、前列地尔用100 ml生理盐水配置、阿司匹林肠溶片掰开服用、高血压患者联用非洛地平和硝苯地平、氯沙坦和贝那普利、哌唑嗪与美托洛尔等。结论 处方自动筛选系统预先提示和筛选的作用,为处方点评工作提供重要的数据支持,并对提高医疗机构合理用药水平起到重要的实际意义。

Objective To comment and analyze on prescriptions by Prescription Automatic Screening System in order to enhance the level of rational drug-usage in hospitals. Methods 1800 outpatient prescriptions were screened by Prescription Automatic Screening System and commented according to the contents and basis. Results There were 2.50 drugs on average per prescription in all of the prescriptions. The rate of antimicrobial usage was 31.41%. The rate of injection rate was 23.21%. The rate of generic name usage was 76.33%. The amount of prescription was 178.39 yuan on average per outpatient. The rate of rational drug-usage was 95.53%. Irrational prescriptions were 81, including 38.27% non-standard prescriptions, 55.56% drug-usage inappropriate prescriptions and 6.17% supernormal prescriptions. There were some mainly problems in these irrational prescriptions, such as not to write a clinical diagnosis or nonstandard diagnosis, upper respiratory tract infections with cefixime, tooth extraction with amoxicillin and roxithromycin, alprostadil with 100ml normal saline, taking broken aspirin enteric-coated tablet, hypertension with felodipine, nifedipine, losartan, benazepril, prazosin and metoprolol. Conclusions Forewarning and screening of prescription automatic screening system that provided important data support for the comments and analysis on prescriptions are playing an important practical significance on improving the level of rational drug-usage in medical institutions.