对本院新型冠状病毒肺炎药物治疗问题的探讨

目的:对本院新型冠状病毒(COVID-9)的药物治疗情况进行分析和探讨,旨在提高该病药物治疗方案的合理性、有效性及安全性。方法:回顾收集1566例COVID-19出院患者的病历资料,统计患者的基本信息、住院情况和治疗用药情况。针对抗病毒药、抗菌药、糖皮质激素、调节免疫药和护肝药的使用特点和存在的问题,进行研析。结果:抗病毒药以阿比多尔、奥司他韦、更昔洛韦应用最为广泛;抗感染药主要莫西沙星和头孢哌酮钠舒巴坦钠;糖皮质激素主要应用甲泼尼龙;免疫调节药主要使用人免疫球蛋白和胸腺肽α1;护肝药主要使用甘草酸二铵和还原性谷胱甘肽等。存在用药问题主要为遴选治疗药不适宜;用药疗程过长;无指征使用和用法用量不适宜等。结论:抗病毒药物治疗问题为奥司他韦和更昔洛韦的遴选不适宜;阿比多尔的用药疗程过长;不推荐3个以上抗病毒药同时使用;利巴韦林应限制使用。抗感染药无指征用药和联合用药的情况较为普遍;关注抗感染药与其他药物之间的相互作用。糖皮质激素主要问题是无指征使用和疗程过长。免疫调节药使用较为合理,需注意普通轻型患者的不合理联合用药。护肝应避免预防性使用多烯磷脂酰胆碱。针对存在的问题应重视临床合理用药。

Discussion on the Drug Treatment of COVID-19 Patients in My Hospital

Objective: To analyze and discuss the drug therapy in a designated hospital in the epidemic area, in order to provide experience for improving the rationality, efficacy and safety of drug therapy for COVID-19 patients. Methods: The medical records of 1566 discharged COVID-19 patients were reviewed, and the basic information, hospitalization and medication of the patients were collected and counted to summarize and discuss the use characteristics and problems of antiviral drugs, antimicrobial drugs, glucocorticoids, immunoregulatory drugs and liver protection drugs. Results: Antiviral drugs such as abidol, oseltamivir and ganciclovir were most widely used. Anti-infective treatment mainly used moxifloxacin, cefoperazone sodium and sulbactam sodium. Methylprednisolone was the most commonly used glucocorticoid drug. The most used immunomodulates were human immunoglobulin and thymosin. Liver protection treatment mainly used diammonium glycyrrhizinate and reduced glutathione. The main problems of drug treatment were improper selection of drugs, long duration of medication, use without indication or improper usage and dosage. Conclusion: The selection of oseltamivir and ganciclovir was not appropriate for antiviral treatment in the hospital. Abidor was used too long. Simultaneous use of more than 3 antiviral drugs is not recommended. The use of ribavirin should be restricted. The use of anti-infective drugs without indication or in combination is common. Clinical attention should be paid to the interaction between anti-infective drugs and other drugs. The main problems with glucocorticoids are the lack of indications and the length of treatment. The use of immunoregulatory drugs is reasonable at large, it should be noted that the combination of drugs in general light patients was not reasonable. The prophylactic use of polyene phosphatidylcholine should be avoided in liver care. Aiming at the problems, it is necessary to promote rational drug use.