马晓玮 顾红燕 栗芳 屠京慧

中图分类号 R984;R969.3 文献标志码 A 文章编号 1001-0408（2021）09-1114-04

DOI 10.6039/j.issn.1001-0408.2021.09.15

摘 要 目的：探讨我院妊娠期妇女门诊用药的合理性，促进临床合理用药。方法：利用医院信息管理系统，抽取首都医科大学附属北京世纪坛医院2019年1-12月全部产科门诊孕妇用药处方，对用药种类、用药频度（DDDs）、安全性级别及中成药使用情况进行统计和分析。结果：我院妊娠期妇女门诊最常使用的是维生素及微量元素类药品，其次为血液系统及激素类药品。安全级别较高的B类药品品种最多，未分级药品的使用情况基本合理，未使用X级药品。妊娠期妇女共使用中成药6种，其中说明书标识“可用”的有2种，说明书未注明的有4种，未使用说明书标识为“禁用”和“慎用”的中成药。结论：我院妊娠期妇女门诊用药总体较为合理，但在孕期使用某些中成药的安全性需进一步证实。

关键词 妊娠期;门诊;用药频度;安全性分级;药师作用

Rationality Analysis of Drug Use of Pregnant Women in the Outpatient Department of Our Hospital

MA Xiaowei1，2，3，GU Hongyan1，2，3，LI Fang1，2，3，TU Jinghui4（1. Dept. of Pharmacy， Beijing Shijitan Hospital Affiliated to Capital Medical University， Beijing 100038， China; 2. Beijing Key Lab of Clinical Rational Drug Use Evaluation， Beijing 100038， China; 3. International Cooperative Joint Laboratory for Clinical Rational Drug Use Evaluation， Beijing 100038， China; 4. Dept. of Obstetrics， Beijing Shijitan Hospital Affiliated to Capital Medical University， Beijing 100038， China）

ABSTRACT   OBJECTIVE： To investigtae the rationality of drug use of pregnant women in the outpatient department of our hospital， and to promote rational drug use in the clinic. METHODS： The prescriptions of pregnant women in Beijing Shijitan Hospital Affiliated to Capital Medical University from Jan. to Dec. in 2019 were extracted by using hospital information management system， and then analyzed statistically in respects of drug varieties， DDDs， safety grading， and use of Chinese patent medicine. RESULTS： The most frequently used drugs in obstetric outpatients were vitamins and microelements， followed by blood system and hormone drugs. Grade B drugs with good safety were most used， the use of ungraded drugs were reasonable， and grade X drugs were not used. There were 6 kinds of Chinese patent medicines used for pregnant women， of which 2 kinds were marked “usable” in the drug instructions， 4 kinds were not marked in the dug instructions， and the Chinese patent medicines that were not marked “prohibited” and “cautious” in the drug instructions were not used. CONCLUSIONS： The drug use of pregnant women  are generally reasonable in outpatient department of our hospital. The safety of some Chinese patent medicine used during pregnancy still needs to be further confirmed.

KEYWORDS   Pregnancy; Outpatient; DDDs; Safety grading; Pharmacist value

妊娠期是女性特殊的生理期，在此期間胎儿正处于发育阶段，各器官尚未完善，而大多数药物可通过胎盘直接或间接影响胎儿的生长发育，因此妊娠期用药对孕妇及胎儿的安全性已成为临床医师和孕妇群体关心的重要问题，也是医院药学研究的重要组成部分。在我国全面放开“二孩”政策的背景下，进入妊娠期的育龄妇女尤其高龄孕产妇增多，故对用药安全问题的关注度也越来越高[1]。通常情况下认为，妊娠期应尽量减少药物应用，然而研究显示，全球妊……