综合性医院在低蛋白血症患者中合理性使用人血白蛋白的回顾性调查  

A retrospective investigation of the rational use of human albumin in treatment of hypoproteinemia in our hospital

作　　者：陈猛[1] 周月红[1] 沈陆斐[2] 

机构地区：[1]嘉兴市第一医院药学部,浙江嘉兴314001 [2]嘉兴市第一医院呼吸科

出　　处：《中华全科医学》2016年第11期1915-1917,共3页Chinese Journal of General Practice

基　　金：浙江省药学会百特医院药学专项科研(2013ZYY44)

摘　　要：目的对某综合性三甲医院住院低蛋白血症患者人血白蛋白的临床用药情况进行回顾性研究，并对低蛋白血症患者使用人血白蛋白医嘱进行合理性点评分析，以提高人血白蛋白治疗低蛋白血症患者的有效性与安全性，促进合理用药。方法利用医院海泰电子病历、美康临床药师软件和medihis（HIS）信息系统调取某三级甲等综合性医院2015年1—6月住院低蛋白血症患者使用人血白蛋白的所有电子医嘱及病例，结合《医院处方点评管理规范（试行）》和《处方管理办法》等进行点评，运用Epidata软件对不合理用药进行汇总。结果研究纳入患者共342例，使用人血白蛋白的患者有178例，住院时间平均为（20．5±5．3）d，白蛋白平均使用疗程为（7．6±1．5）d，人均白蛋白使用量为（63．4±9．6）g，引起低蛋白血症患者原因较为复杂，原发疾病以呼吸系统及消化系统疾病较为常见，用药前患者血清白蛋白浓度多集中于20～30g/L之间，占85．4％，不合理用药医嘱共22例，占12．4％，其中不规范用药医嘱6例，占不合理医嘱总数的27．3％，用药不适宜医嘱14例，占不合理医嘱总数的68．2％，超常用药医嘱1例，占不合理医嘱总数的4．5％，人血白蛋白不合理医嘱使用例次以20％人血白蛋白居多，不合理医嘱所占比以5％人血白蛋白居多。结论人血白蛋白在低蛋白血症患者中使用较为普遍，存在不合理用药现象，应进一步加强白蛋白处方点评制度的实施，促进人血白蛋白的安全、合理使用。Objective To investigate the use of human albumin in treatment of hypoproteinemia in our hospital, and to provide reference for rational use of drug in the clinic. Methods Using a pharmacy administration software of Haitai, Meikang and HIS,all cases of the human albumin and recipes from January to June in 2015 were reviewed ,the irrational drug ntilization recipes were summarized by EpiData software and evaluated in accordance with hospital Prescription Eval- uation Management Norms （Trial） and Prescription Management Norms. Results Total 342 cases hypoproteinemia were enrolled, and 178 inpatients were prescripted of human albumin, the average hospital stay was 20.5 ± 5.3 days, the aver- age treatment course and consumption of human albumin were 7.6 ±1.5 days and （ 63.4 ± 9.6 ） g, respectively. The re- spiratory and digestive diseases were the two primary causes of hypoproteinemia. The most of the patients were with a lower level of serum albumin （ between 20 g/L and 30 g/L, accounting for 85.4% ） before the use of serum albumin. There were 22 cases of irrational prescriptions of human albumin, accounted for 12.4% of the all prescriptions,in which 6 cases were the nonstandard prescriptions that accounted for 27.3% , and 14 cases of unsuitable prescriptions that accounted for 68.2%, and 1 case of abnormal prescriptions that accounted for 4.5%. The amount of 20% human albumin took the ma- jority of irrational albumin prescriptions, while the amount of 5 % human albumin took the highest rate of irrational albu- min prescriptions. Conclusion Human albumin was used widely in the treatment of hypoproteinemia in our hospital, in which some cases are irrational. We should develop the drug using standard of human albumin and strictly grasp the indi- cations of drug use to promote the safety and rational use of human albumin.

关 键 词：人血白蛋白 合理用药 调查分析 低蛋白血症 

分 类 号：R591.2[医药卫生—内科学] R973[医药卫生—临床医学]