ABSTRACT
In the past, hernia and abdominal wall surgery has been ignored, which may endanger the life of patients due to untimely treatment. In 1997, the concept of tension-free hernia repair was introduced to China. Chinese hernia and abdominal wall surgery entered a new era and developed rapidly. In 2015, scholars in China decided to create our own Hernia Registry. In 2017, Hernia Registry was officially released, and the Chinese Hernia Surgery Alliance was established in the same period. The Chinese Hernia Registry has became the second largest Hernia clinical registry database in the world. Although the follow-up rate needs to be improved, it is possible to have a preliminary understanding and analysis of the incidence of hernia disease in China. There are many difficulties in its application, and it requires the multi-level coordination and long-term commitment. The authors hope that through this work, the diagnosis and treatment of hernia and abdominal wall can be improved, and the ability of communication and cooperation at home and abroad will be enhanced, benefiting the general population of hernia patients.
ABSTRACT
OBJECTIVE: To evaluate the appropriateness of nonsteroidal anti-inflammatory drugs (NSAIDs) used in the perioperative period. METHODS: This was a retrospective multicenter study with three stages: ①characterization of the application of NSAIDs through questionnaires; ②establishment of an expert group and development of the standard for prescription evaluation; ③random enrollment of cases using NSAIDs during the perioperative period from October 2016 to March 2017 and evaluation of prescriptions. RESULTS: The study was conducted in 16 tertiary-care hospitals and included 960 cases. NSAIDs were commonly used in 15 hospitals (93.8%) during the perioperative period. Flurbiprofen axetil injection, parecoxib sodium injection and celecoxib capsule were NSAIDS with the top three expenses. Ten (62.5%) hospitals did not routinely intervene for the irrational use of NSAIDs, and only two (12.5%) hospitals established the regulatory regime of NSAIDs.The overall irrational rate was 23.3% (n=224). Too long continuous medication duration and inappropriate combination of NSAIDs were the main problems, involving 98 cases (10.2%) in 10 hospitals and 76 cases (7.9%) in 11 hospitals, respectively. Other problems were: 26 cases (2.7%) used drugs beyond contraindication, and 24 cases (2.5%) administrated drugs in irrational route.CONCLUSION: NSAIDs are widely used in the perioperative period. Lack of regulatory regime, insufficient clinical intervention and irrational prescriptions are the current status of NSAIDs usage. Therefore, it is necessary to take powerful measures and effective pharmaceutical intervention to improve the use of NSAIDs.