Objective To establish drug use evaluation (DUE) criteria for aminocaproic acid injection, and to evaluate and analyse clinical use of aminocaproic acid injection.
Methods Based on the aminocaproic acid injection drug label, DUE of aminocaproic acid injection from three aspects(indications, medications and medication results)were established with reference to relevant literature. A retrospective survey was conducted to evaluate the rationality of medication for inpatients who used aminocaproic acid injection from July 1, 2021 to June 30, 2022 in Fuding Hospital of Fujian University of Traditional Chinese Medicine.
Results A total of 143 midical records were included. 73 cases fully met the DUE criteria, 70 cases did not fully meet the DUE criteria, and the unreasonable rate was 48.95%. The most common types of irrational using of aminocaproic acid injection were inappropriate timing of perioperative prevention of medication (26.57%), overcourse in perioperative prevention of medication (23.08%), and contraindications (7.69%).
Conclusions The aminocaproic acid injection DUE standard established is scientific, practical, the irrational rate of aminocaproic acid injection use is relatively high in this hospital, and the management of rational use of aminocaproic acid injection needs to be strengthened.
1.林小娟, 黄小红, 黄涓涓, 等. 利伐沙班药物利用评价标准的建立与应用[J].中国现代应用药学, 2020, 37(20): 2543-2548. [Lin XJ, Huang XH, Huang JJ, et al. Establishment and application of drug use evaluation standard of rivaroxaban[J]. Chinese Journal of Modern Applied Pharmacy, 2020, 37(20): 2543-2548.] DOI: 10.13748/j.cnki.issn1007-7693.2020.20.020.
2.方煜, 胡明, 陈麒骏, 等. 国内药物利用评价研究的文献计量学分析[J]. 中国药房, 2014, 25(44): 4135-4139. [Fang Y, Hu M, Cheng QJ, et al. Systematic review of domestic drug use evaluation research[J]. China Pharmacy, 2014, 25(44): 4135-4139.] DOI: 10.6039/j.issn1001-0408.2014.44.03.
3.蒋学华, 主编. 药物现代评价方法[M]. 北京: 人民卫生出版社, 2008: 1-9.
4.叶鸣, 赵磊, 方佳, 等. 骨科围手术期抗凝药物及氨基己酸合理使用评价[J]. 中南药学, 2021, 19(8): 1721-1725. [Ye M, Zhao L, Fang J, et al. Rational use of anticoagulants and aminocaproic acid in orthopedic perioperative period[J]. Central South Pharmacy, 2021, 8(19): 1721-1725.] DOI: 10.7539/j.issn.1672-2981.2021.08.042.
5.徐军, 戴佳原, 尹路. 急性上消化道出血急诊诊治流程专家共识[J]. 中国急救医学, 2021, 41(1): 1-10. [Xu J, Dai JY, Yi L. Expert consensus on the emergency diagnosis and treatment process of acute upper gastrointestinal bleeding[J]. Chinese Journal of Critical Care Medicine, 2021, 41(1): 1-10.] DOI: 10.3969/j.issn.1002-1949.2021.01.001.
6.北京医师协会呼吸内科专科医师分会咯血诊治专家共识编写组. 咯血诊治专家共识[J]. 中国呼吸与危重监护杂志, 2020, 19(1): 1-11. DOI: 10.7507/1671-6205.201911006.
7.周宗科,黄泽宇,杨惠林,等. 中国骨科手术加速康复围手术期氨甲环酸与抗凝血药应用的专家共识[J].中华骨与关节外科杂志, 2019, 12(2): 81-88. [Zhou ZK, Huang ZY, Yang HL, et al. Expert consensus on the application of tranexamic acid and anticoagulantfor the enhanced recovery after orthopedic surgery in China[J]. Chinese Journal of Bone and Joint Surgery, 2019, 12(2): 81-88.] DOI: 10.3969/j.issn.2095-9958.2019.02.01.
8.陈旺, 冯硕, 张羽, 等. 氨甲环酸和ε-氨基己酸减少全膝关节围置换期失血有效和安全性的Meta分析[J].中国组织工程研究, 2021, 25(15): 2430-2436. [Chen W, Feng S, Zhang Y, et al. Efficacy and safety of tranexamic acid and epsilon-aminocaproic acid in reducing perioperative blood loss during total knee arthroplasty: a meta-analysis[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(15): 2430-2436.] DOI: 10.3969/j.issn.2095-4344.3821.
9.Chapin JC, Hajjar KA. Fibrinolysis and the control of blood coagulation[J]. Blood Rev, 2015, 29: 17. DOI: 10.1016/j.blre.2014.09.003.
10.国家医保局人力资源社会保障部. 国家基本医疗保险、工伤保险和生育保险药品目录(2021年)[EB/OL].(2021-11-24) [2023-08-16]. http://www.gov.cn/zhengce/zhengceku/2021-12/03/content_5655651.htm.
11.Martino JP. The delphi method: techniques and applications[J]. Technologic Forecast Social Change, 1976, 8(4): 441-442. DOI: 10.2307/3150755.
12.CRASH-2 Trial Collaborators, Shakur H, Roberts I, et al. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial[J]. Lancet, 2010, 376: 23-32. DOI: 10.1016/S0140-6736(10)60835-5.
13.WOMAN Trial Collaborators. Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women withpost-partum haemorrhage (WOMAN): an international, randomised,double-blind, placebo-controlled trial[J]. Lancet, 2017, 389: 2105-2116.DOI: 10.1016/S0140-6736(17)30638-4.
14.Schutgens REG, Lisman T. Tranexamic acid is not a universal hemostatic agent[J]. Hemasphere, 2021, 5(8): e625. DOI: 10.1097/HS9.0000000000000625.
15.Nordestgaard AG, Bodily KC, Osborne Jr RW, et al. Major vascular injuries during laparoscopic procedures[J]. Am J Surg, 1995, 169(5): 543-545. DOI: 10.1016/s0002-9610(99)80214-1.
16.罗序睿, 黄亮. 氨基己酸临床用药的研究现状[J]. 中国临床药理学杂志, 2022, 38(16): 1967-1971, 1976. [Luo XR, Huang L. Research status on the clinical application of aminocaproicacid[J]. Chinese Journal of Clinical Pharmacology, 2022, 38(16): 1967-1971, 1976.] DOI: 10.13699/j.cnki.1001-6821.2022.16.028.
17.王晓梅, 金烈洲, 丁洁卫. 医嘱集中点评模式下联合干预对外科围术期止血药应用的影响[J]. 中国临床药学杂志, 2018, 27(4): 272-276. [Wang XM, Jing LZ, Ding JW. The effect of combined intervention on the application of hemostatic drugs in the centralized review mode[J].Chinese Journal of Clinical Pharmacy, 2018, 27(4): 272-276.] DOI: 10.19577/j.1007-4406.2018.04.013.
18.Boese CK, Centeno L, Walters RW. Blood conservation using tranexamic acid is not superior to epsilon-aminocaproic acid after total knee arthroplasty[J]. J Bone Joint Surg Am, 2017, 99(19): 1621-1628. DOI: 10.2106/JBJS.16.00738.
19.Churchill JL, Puca KE, Meyer E, et al. Comparing ε-aminocaproic acid and tranexamic acid in reducing postoperative transfusions in total knee arthroplasty[J]. J J Knee Surg, 2017, 30(5): 460-466. DOI: 10.1055/s-0036-1593362.