摘要
目的:探讨别嘌醇医疗损害责任纠纷发生的规律及特点,为临床合理用药提供参考。方法:以别嘌醇为关键词,检索中国裁判文书网,时间为2010年1月～2018年8月的医疗损害责任纠纷的裁判文书,用Excel表建立评价表数据库,对文献检索基本情况、发生纠纷的药品不良反应(ADR)临床表现和裁判文书内容等进行统计分析。结果:共检索到裁判文书45例,纳入裁判文书16例,其中男9例,女6例,不详1例,年龄最小30岁,最大83岁,不详3例,平均年龄60岁,年龄大于60岁8例,占50.0%。引起别嘌醇损害纠纷的主要ADR为严重皮肤过敏反应,共13例,占81.2%;ADR诱导期最短的为用药后3 d,最长的为用药后32 d,平均为用药后18.81 d;经停药和治疗后,4例好转,12例死亡。16例裁判文书3例为调解,13例为判决,判决的责任范围在10%～100%。结论:别嘌醇最严重的不良反应为严重皮肤过敏反应,严重者可导致患者死亡,因此,要加强对其不良反应的重视、认识和监测,提高合理用药水平,减少不良反应的发生。
Objective:To explore the regularity and characteristics of the medical damage liability dispute induced by allopurinol, to provide reference for clinical rational drug use. Methods:The China judgements online(CJO) databases had been searched using the mesh keywords of "allopurinol" from January 2010 to August 2018. The evaluation table database was established with the Excel table to conduct statistical analysis on the basic information of literature search, clinical performance of dispute ADR and the content of judicial documents. Results: A total of 45 cases of judgements documents were retrieved, and 16 cases were enrolled. Among them, 9 cases were male, 6 cases were female, and 1 case was unknown. The minimum age, maximum age and average age were 30, 83 and 60, respectively. About 3 cases were unknown. and 8 cases were older than 60 years(accounting for 50.0%). The main ADR involved in allopurinol damage was SCARs(13 cases), accounting for 81.2%. The shortest induction period of ADR was 3 d after administration, while the longest was 32 days, and the average was 18.81 d. After treatment, About 4 cases were improved and 12 cases died by withdrawal or treatment. There were 16 cases of judgments documents, among which 3 cases were mediation and 13 cases were judgment. The responsibility scope of the judgment was 10%-100%. Conclusion:The most serious adverse reactions of allopurinol are SCARs, which may lead to death of patients in severe cases. Therefore, attention, awareness and monitoring should be strengthened for the ADRs, so as to strengthen the guidance of rational drug use, improve the level of rational drug use and reduce the occurrence of ADRs.
作者
郑造乾
骆瑾瑜
Zheng Zaoqian;Luo Jinyu(Department of Pharmacy,Tongde Hospital of Zhejiang Province,Hangzhou 310012,China;Medical Department,Tongde Hospital of Zhejiang Province,Hangzhou 310012,China;Hemopurification Center,Tongde Hospital of Zhejiang Province,Hangzhou 310012,China)
出处
《药物流行病学杂志》
CAS
2019年第3期167-169,175,共4页
Chinese Journal of Pharmacoepidemiology
基金
浙江省药学会医院药学专项科研资助项目(编号:2013ZYY03)
关键词
别嘌醇
医疗损害责任纠纷
药品不良反应
中国法律文书网
Allopurinol
Medical damage liability dispute
Adverse drug reaction
China judgements online
