中国临床药学杂志

目的 建立那屈肝素钙药物利用评价（DUE）标准，评价屈肝素钙的临床应用合理性，为临床合理使用屈肝素钙提供参考。方法 成立合理用药评价小组，基于循证医学/药学证据建立那屈肝素钙DUE标准，利用属性层次模型对那屈肝素钙的临床使用进行合理性评价。结果 那屈肝素钙围手术期预防性使用不合理问题较多，内科科室那屈肝素钙使用合理率高于外科科室。那屈肝素钙使用不合理问题主要为用法用量不合理（281例，占82.40%）、未开展实验室监测（178例，占52.20%）和用药时机不合理（156例，占45.75%）。病历得分为（73.16±9.91）分，评价等级为合格和良好的病例分别占比57.77%和34.90%。结论 建立的那屈肝素钙DUE标准具有科学性，可用于那屈肝素钙的临床合理性评价。该院那屈肝素钙的临床使用存在一些不合理问题，使用那屈肝素钙的病历评价等级主要为合格和良好，优秀和不合格的病例较少。临床应重视那屈肝素钙使用中存在的不合理问题。

AIM To establish the drug use evaluation(DUE) criteria of nadroparin calcium, and evaluate its ratonality of clinical application, providing a reference for rational clinical use. METHODS A rational drug use evaluation team was set up to establish the DUE criteria of nadroparin calcium based on the evidence-based medical/pharmacy evidence. The attribute hierarchical model(AHM) method was used to evaluate the rationality of clinical use of nadroparin calcium. RESULTS During the perioperative period, there were many unreasonable prophylactic uses of nadroparin calcium in the medical records of this evaluation, with the rational rate of use being higher in the internal medicine department compared to surgical department. The primary issues with the unreasonable clinical use of nadroparin calcium were improper use and dosage(281 cases, 82.40%), lack of laboratory monitoring(178 cases, 52.20%), and inappropriate timing of medication administration(156 cases, 45.75%). The medical record score(MRS) was(73.16 ± 9.91) points, with cases rated as qualified and good accounting for 57.77% and 34.90%, respectively. CONCLUSION The DUE criteria of nadroparin calcium established are scientific and feasible to evaluate the rationality of nadroparin calcium for clinical use. There are certain concerns regarding the clinical use of nadroparin calcium in the hospital. The evaluation grades for medical records concerning nadroparin calcium are mostly categorized as qualified or good, with very few cases rated as excellent or unqualified. Clinicians need to pay attention to the unreasonable use of nadroparin calcium.