| Liver transplantation has become widely recognized as the only effec-tive means of treatment of end-stage liver disease.Since the1970 s in china, the introduction of liver transplantation has achieved significant development, to save the lives of thousands of patients with liver disease, Currently liver transplant surgery itself is no longer a major factor restricting the development of liver transplantation, and the high incidence of postoperative complications are still threatening the lives of patients, immune rejection and infection of that are the key factors affecting the receptor survival after liver transplantation. Tacrolimus(FK506), Mycophenolate Mofetil Capsules are applied successfully as a new type of immunosuppressive agents to make the threat of the body rejection to the receptor survival more and more smaller; and because of the irrational use of antibiotics and bacterial resistance potencyincreasing,infection has become an important reason that threat the postoperative patients quality of life.Liver transplantation is a high risk, high cost surgery, and patients need to bear a heavy financial burden. Years of clinical data show that after liver transplant,patients often present with acute and chronic rejection, postoperative infection, electrolyte imbalance, secondary complications of diabetes, so they need a plenty of drugs. For some drugs, the individual pharmacokinetic differences in the patients are big, so that make the choose of drugs and the science and rational clinical use more difficult. In addition postoperative immunosuppression and acute rejection reaction of shock therapy make the infection of the liver transplant patients in perioperative probability is much higher than other surgical patients, so drugs for liver transplant patients are numerous and complex,and the select of drug interactions, correct scientificrationality and combined effects of drugs are the complicated issues.In this study, to understand the situation of drug use and expenditures for liver transplant patients in our hospital during liver transplant patients hospitalized prescription drugs statistical analysis, the system in order to further provide basis for liver transplantation intreatment selection, route of administration, dosage and other clinical applications. The first part 100 cases of liver transplantation in patients with drug analysisObjective: Statistical analysis of our hospital 100 cases of liver transplantation in patients with the use of drug and expenditures have provide evidence in drug selection, route of administration, dosage and other clinical applications for liver transplant patients.Methods: Survey of 100 parts of cases in our hospital liver transplant patients from 2005 to 2014 is carried on,including age, sex, length of stay, etiology and other basic information that is recorded; and their drug type, dose, frequency of administration, and from 2005 to 2014 hospital costs of the patients were aggregated using Excel for statistical processing.Result: Execution prescription drugs, involving 470 kinds of drugs. Among them, theelectrolyte balance regulating drugs, vitamins and nutritional medicine, immune therapy, circulatory system drugs, blood system drugs and anti-infective drugs appear higher frequency in the doctor’s advice, and accounted for more than 80 percent of drugs used;human serum albumin, immunoglobulin,tacrolimus, mycophenolate mofetil, omeprazole, methylprednisolone, etc. which appears in the maximum frequency and maximum number as a single product, display orientation in these patients and their treatment of special populations are closely related. Drug costs, the total cost of hospitalization and the ratio between the mean, respectively:(119.4± 54.9) thousand yuan,(245.1 ± 110.5)thousand yuan,(48.68 ± 9.12)%. Impact of hospital costs is mainly caused by the preoperative physical state and the degree of ICU bound postoperative, infection and other factors.Conclusion: After liver transplantation,there no significant growth of total hospital in the patients, but the drug costs have a higher proportion of total costs. Hospital treatment consistent with the positioning of this special population. The second part Investigation and analysis of the application of anti-infective drugs in liver transplant patientsObjective: To analyze the application of anti-infective drugs in perioperative liver transplant patients to provide the basis for the rational use of anti-infective drugs.Methods: A retrospective survey conducted in 2005 1 Month- December 2014 after liver transplantation discharged 100 medical records, using the World Health Organization(WHO) recommended drug utilization research team defined daily dose(DDD), drug usefrequency(DDDs) and drug utilization index(DUI) as an indicator of the patients surveyed medication use Excel for statistical analysis.Result: In 100 cases of liver transplantation, patients with anti-infective drug use was 100.0%, anti-infective medication longest continuous 46 d, the shortest 8 d, average(18.2±1.8) d; in which two or more anti-infective drugs combined continuous time longest 38 d, the shortest 3d. Applications for the longest single species 34 d, the shortest 1 d. 61 patients were treated with combination therapy had applied frequency of 61.00%; 43 cases in which the two linked, accounting for43.00%, triple 18 cases, accounting for 18.00%;Statistical Application Example / top-10 of the anti-infective drugs except cefepime DUI =1.03, the other drugs DUI were <1.Conclusion: Liver transplant recipients frequency of use of anti-infective drugs, medication time and combined cases were higher than other surgical patients, which with its particularities related to postoperative infection. The group of 61 patients in the combination of anti-infective drugs, combined with its varieties showed synergistic or additive anti-inflammatory effects, are reasonable compatibility. |
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