目的 分析2019—2021年复旦大学附属妇产科医院住院患者低分子肝素的使用情况，并评价其合理性，为妇产科低分子肝素合理性使用提供数据资料。方法 采用回顾性研究方法，从复旦大学附属妇产科医院住院医院信息系统（HIS）中查询2019年1月—2021年12月使用低分子肝素的病史信息，包含患者年龄、科室、出入院诊断、手术名称、药品名称及规格、使用频次、单次剂量和给药途径等。结果 2019—2021年使用低分子肝素的患者共54 138例，其中产科14 068例，妇科40 070例。产科年龄分布在19～35岁，妇科年龄分布在41～60岁。诊断为静脉血栓栓塞的患者共102例，妇科患者居多，占比90.20%。预防用药方面，产科剖宫产患者居多，占比63.25%；妇科为手术患者，占比98.06%，妇科恶性肿瘤的患者占比26.28%。产科及妇科患者预防用药和治疗性用药疗程主要集中在1～7 d，不合理的用法用量主要表现为给药途径不合理、单次剂量超限和给药频次不合理等，共64例，占比0.12%。结论 2019—2021年复旦大学附属妇产科医院低分子肝素的使用以预防使用为主。产科以剖宫产患者为主，妇科以手术患者为主，用法用量基本合理。

Objective To analyze the use of low molecular weight heparin in inpatients of Obstetrics and Gynecology Hospital Affiliated to Fudan University from 2019 to 2021, and evaluate its rationality, providing data for rational use of low molecular weight heparin in obstetrics and gynecology. Methods Using retrospective study method, from the department of Obstetrics and Gynecology Hospital Affiliated to Fudan University (HIS) query from January 2019 to December 2021 history of low molecular weight heparin information, include patients' age, department, diagnosis, surgery, descriptions, and specifications of drugs, frequency of usage, the single dose and method, etc. Results A total of 54 138 patients received low molecular weight heparin from 2019 to 2021, including 14 068 in obstetrics and 40 070 in gynecology. The obstetrical age ranged from 19 to 35 years, and the gynecological age ranged from 41 to 60 years. A total of 102 patients were diagnosed as venous thromboembolism, most of which were gynecological patients, accounting for 90.20%. In terms of prophylactic drugs, the majority of patients were caesarean section, accounting for 63.25%, gynecological surgery patients accounting for 98.06%, gynecological malignant tumor patients accounted for 26.28%. The prophylactic and therapeutic medication courses of obstetrics and gynecology patients mainly focus on 1 to 7 d. Unreasonable usage and dosage were mainly manifested as irrational administration route, single dose exceeding limit, and irrational administration frequency, 64 cases in total, accounting for 0.12%. Conclusion The use of low molecular weight heparin in Obstetrics and Gynecology Hospital Affiliated to Fudan University from 2019 to 2021 was mainly preventive. Obstetrics to cesarean delivery patients, gynecology to surgery patients, the usage and dosage is basically reasonable.

R972

上海市"医苑新星"青年医学人才培养资助计划(沪卫计人事[2019]72号)