中国临床药学杂志

目的 评价基于《质子泵抑制剂临床应用指导原则（2020年版）》及美国学者HERZIG等建立的消化道出血风险评分系统和温爱萍等通过Delphi法建立的围术期非重症患者应激性溃疡（SU）出血预防用药合理性评价指标体系建立的评价标准1、评价标准2和评价标准3评估非重症疝气围术期患者SU预防用药指征的一致性，为选择适宜的非重症围术期SU预防用药指征的评价标准提供参考。方法 收集2021年4月1日至9月30日非重症疝气围术期患者的信息，采用3种评价标准评估其SU预防用药指征情况，并进行比较。结果 纳入患者303例，使用评价标准1、评价标准2和评价标准3评估的具有用药指征的患者，例数分别为33例（10.89%）、13例（4.29%）和61例（20.13%），两两比较3种评价标准，评估结果的一致性均较差，评价标准1 vs评价标准2、评价标准1 vs评价标准3和评价标准2 vs评价标准3的Kappa值分别为0.073(P=0.149)、0.232(P <0.01)和0.302(P <0.001)。结论 3种评价标准评估非重症疝气围术期患者SU预防用药指征的一致性较差。

AIM To evaluate the consistency of criterion 1, criterion 2 and criterion 3 which respectively based on Guiding Principles for Clinical Application of Proton Pump Inhibitors(2020 Edition), clinical risk scoring system for nosocomial gastrointestinal bleeding established by HERZIG et al, and evaluation index system for rationality of prophylactic medication for stress ulcer(SU) bleeding in perioperative non-critical patients established by Wen et al for evaluating the prophylactic indication for stress ulcer in non-severe patients with hernias during the perioperative period,and to provide a reference for selecting appropriate criteria for non-severe patients during perioperaive period. METHODS The information of non-severe patients with hernias during the perioperative period from April 1 to September 30 in 2021was collected, and their prophylactic indication for SU was evaluated and compared using three criteria respectively. A total of 303 patients were included, and the number of patients with prophylactic indications for SU assessed by criterion 1,criterion 2 and criterion 3 were 33(10.89%), 13(4.29%) and 61(20.13%), respectively. The consistency of the evaluation results of the three criteria was poor. The Kappa values for criterion 1 vs criterion 2, criterion 1 vs criterion 3 and criterion 2 vs criterion 3 were 0.073(P=0.149), 0.232(P<0.01) and 0.302(P<0.001), respectively. CONCLUSION The evaluation results of the three criteria are poorly consistent.