目的:了解首都医科大学附属北京儿童医院(以下简称"我院")药品使用情况,为药品精细化管理提供依据.方法:采用ABC分析法(activity based classification,简称ABC分析法)、关键-基本-非基本药物(vital essential nonessential,VEN)分析法和ABC-VEN矩阵分析法,对2018年9月至2019年8月我院门诊及住院患儿使用药品的品种、金额进行统计分析,同时进行库存周转分析、用量分析.结果:2018年9月至2019年8月我院门诊及住院患儿共使用药品698种,销售金额66932.21万元.基于ABC分析法,A、B和C类药品的品种数构成比依次为15.90％(111种)、20.20％(141种)和63.90％(446种),金额构成比依次为79.85％(53444.13万元)、15.10％(10108.14万元)和5.05％(3379.94万元).基于VEN分析法,V、E和N类药品的品种数构成比依次为35.10％(245种)、54.44％(380种)和10.46％(73种),金额构成比依次为29.30％(19611.22万元)、63.82％(42718.59万元)和6.88％(4602.40万元).结合ABC-VEN矩阵分析,品种数构成比最高的为CE类药品(31.52％,220种),金额构成比最高的为AE类药品(51.76％,34647.20万元),品种数构成比最低的为AN类药品(0.86％,6种),金额构成比最低的为CN类药品(0.66％,441.18万元).结论:应适当调整我院CV、CE类中部分药品的库存上下限,以保证临床必需用药的供应,减少药品短缺的发生;AE、AN类药品中存在一些国家重点监控药品,减少其使用不仅可降低药品费用,而且有助于促进临床合理用药.将ABC分析法与VEN分析法相结合分析一段时间内医院药品使用情况,是将科学方法运用到实际工作中,可为药品库存的细化管理以及临床合理用药提供数据支持.

目的 分析疫情时期基于信息化平台对应用孟鲁司特钠的患儿进行全程持续化药学服务的意义.方法 通过医院信息系统调取2020年3月至6月我院门诊患儿使用孟鲁司特钠的处方,统计患儿年龄、性别、临床诊断、药品用法和用量及科室分布等临床资料.利用微信平台随机对100例使用孟鲁司特钠的患儿进行院外随访,定期发布科普知识,监测不良反应.结果 本研究共纳入5 842张处方,在所有处方中,患儿年龄以2～5岁居多(52.48％),其次为6～14岁(41.34％).在规格和剂型方面,2岁以下患儿使用咀嚼片处方79张,1岁以下患儿使用颗粒剂及咀嚼片处方67张.孟鲁司特钠适应证的临床诊断以过敏性鼻炎为主(45.67％),其次为过敏性鼻炎/哮喘合并其他疾病(33.26％),哮喘(16.54％),咳嗽变异性哮喘(3.75％),闭塞性细支气管炎占0.77％.随访的107例家属中,有100例愿意接受临床药师监测随访.随访中,1例家属反馈患儿在用药后出现了脾气暴躁.结论 我院孟鲁司特钠处方基本合理,但在剂型选择、并发症、跨科室开处方等方面仍存在部分用药风险.依托微信平台进行院外随访的模式符合大多数家属意愿,进一步开通专线自主报告的方式可扩大使用,实现对孟鲁司特钠的全程持续化药学服务,为临床合理用药提供依据.

Objective:In order to provide reference for the drug shortage in our hospital.Methods:The data of shortages of medicines reported by centralized purchasing platform from January 2014 to December 2015 were collected,numbers of shortages of medicines and drug specifications,dosage form,causes of shortages and price were analyzed.Results:From January 2014 to December 2015 in our hospital,we reported shortages of medicines 350 times,a total of 117 drug specifications,injection accounted for 53.85％ and shortage due to raw material drug shortages and small demand,enterprise production accounted for 54.7％,single package units less than 5 yuan of the shortage of medicines accounted for 34.19％.Conclusion:Long term shortage of drugs will seriously affect clinical treatment,the shortage of the dosage forms is related to the particularity of the drug used in our hospital,drug's price is related to drug shortages,the national sentinel production will help to improve the shortage of drugs.

Objective:To study the application of microecological modulators in our hospital.Methods:11 459 pieces of prescription were picked out from the months of January,April and August,2006,in our hospital.Among them,there were 693 pieces of microecological modulator pre- scription.The application of microecological modulators was studied and also their combined application with antibiotics and with medicaments for alimentary system disorder,and then its rationality was analyzed.Results:The prescriptions of,or including microecological modulators took 6.05% of all the prescriptions chosen,with Live Combined Bifidobacterium,Lactobacillus and Enterococcus Powder(Bifico)at the top,taking up to 40.12%. The combined application with antibiotics was 44.15%,and the combined application of two mieroecological modulators was 0.72%.and no com- bined application of more than two microecological modulators were found.Conclusions:There are some unreasonable applications of mieroecologi- cat modulators in our hospital,to which a special attention must be paid by beth physicians and pharmacists.

目的:评价治疗小儿支气管肺炎的三种药物治疗方案的成本-效果分析。方法:选择32例小儿支气管肺炎患者,分为A、B、C三组,进行药物经济学的成本-效果分析。结果:C组(注射用阿奇霉素即齐宏)治疗方案效率最高,成本最低。结论:大环内酯类抗生素阿奇霉素治疗支气管肺炎效果好,但不良反应也较多,有待于进一步研究。

北京儿童医院是中国最大的儿科综合医院,日门诊量平均5 000人次,拥有病床700余张.要科学、合理地满足这样一家庞大的医疗机构用药,药库工作的难度可想而知.因此,药库的管理者不仅要有足够的药学、医学专业知识,还要有一定的管理知识,反复思考,不断提高,做到让患者、医师、护理人员都对药学部门满意.笔者就目前我院药库的管理模式进行了分析,找出了一些不足之处,并提出自己认为可行的改进方法.