目的 评价广州市红十字会医院利伐沙班片临床应用的合理性，提升临床合理用药水平。方法 收集广州市红十字会医院2017-2018年应用利伐沙班片的住院患者病历共358份，对利伐沙班片临床应用的适应症、用法用量、用药时机、疗程、禁忌症进行系统的回顾性调查分析。结果 利伐沙班主要应用于非瓣膜性房颤、外周动脉疾病、深静脉血栓、静脉血栓栓塞高危患者和骨科大手术患者。利伐沙班片用药不合理共174例（48.6%），其中用法用量不合理140例（42.42%）、超适应症用药28例（7.82%）、用药时机不合理7例（20.59%）、用药疗程不合理11例（32.35%）和存在用药禁忌5例（1.4%）。结论 目前利伐沙班片在临床应用中仍存在一些不合理现象，应积极开展利伐沙班片的临床药学服务，促进其合理使用。

Objective To evaluate the clinical reasonable use of Rivaroxaban Tablets in Guangzhou Red Cross Hospital, to improve the level of rational use of drugs. Methods Totally 358 medical records with Rivaroxaban Tablets in Guangzhou Red Cross Hospital from 2017 to 2018 were selected, and the indication, usage and dosage, drug use time, course of treatment, and contraindication of Rivaroxaban Tablets were systematically analyzed. Results The common clinical indications for Rivaroxaban Tablets use were patients with non-valvular atrial fibrillation, peripheral artery disease, deep vein thrombosis, VTE high risk patients or that patients undergoing orthopaedics surgery. Among the 358 medical records, totally 174 cases (48.6%) were irrational. There were 140 cases of improper usage and dosage, which accounted for 42.42%. Off-label medication were 28 cases (7.82%). There were 7 cases (20.59%) of improper drug administration time, 11 cases (32.35%) of improper treatment course, and 5 cases (1.4%) of rational indications without contraindication. Conclusion At present, the clinical application of Rivaroxaban Tablets is still deficient, therefore, clinical pharmacy services of rivaroxaban should be actively carried out, and to promote the rational use of Rivaroxaban Tablets.

R969.3

广东省医学科学技术研究基金资助项目（A2017165）