全肠外营养管控软件研发及其对医嘱合理性的影响  

Development and clinical application of total parenteral nutrition control software

作　　者：邵芸[1] 王增[1] 杨国浓[1] 赵晴峰[2] 陈凌亚[1] 陈芳君[1] 陈培[1] 骆虹[1] 曹莹莹[1] SHAO Yun;WANG Zeng;YANG Guonong;ZHAO Qingfeng;CHEN Lingya;CHEN Fangjun;CHEN Pei;LUO Hong;CAO Yingying(Department of Pharmacy;Department of lnformation,Zhefiang Cancer Hospital, Hangzhou 310022, China)

机构地区：[1]浙江省肿瘤医院药剂科,杭州310022 [2]浙江省肿瘤医院信息科,杭州310022

出　　处：《中国临床药学杂志》2018年第1期47-50,共4页Chinese Journal of Clinical Pharmacy

基　　金：浙江省医药卫生科技计划(编号2014KYB039);浙江省中医药科技计划(编号2016ZA038);浙江省肿瘤医院"1022"人才项目;2017年浙江省药学会医院药学专项科研资助项目(编号2017ZYY14)

摘　　要：目的介绍肿瘤专科医院由药师主导的全肠外营养(TPN)管控软件的研发,评价TPN管控软件的应用对TPN医嘱合理性的作用。方法基于医院信息系统(HIS、EMR),药师联合信息科技术人员共同开发适合肿瘤专科医院TPN使用的管控软件。采用回顾性调查方法,抽取该院2015年第二、四季度的结直肠恶性肿瘤手术患者病历共387份,其中TPN管控软件应用前200例,应用后187例。利用Excel表格数据自动筛选、分类汇总,再采用SPSS 20.0统计软件分析,评价由药师主导的TPN管控软件的临床应用对TPN医嘱合理性的影响。结果 TPN管控软件主要对总热量、糖脂比、热氮比、液体量、电解质等指标进行管控。其中,TPN管控软件应用前后,结直肠癌手术患者在性别、年龄、疾病类型、PS评分、体质量指数等方面差异均无统计学意义(P>0.05);而TPN中的总热量、电解质的离子浓度、糖脂比、热氮比、丙氨酰谷氨酰胺使用合理性方面差异均存在统计学意义(P<0.05)。结论肿瘤专科医院药师主导的TPN管控软件在临床的应用有助于提高TPN医嘱的合理性。AIM To introduce the research and development of total parenteral nutrition （TPN） control software which was led by pharmacists in cancer specialized hospital, and evaluate the effect of the application of TPN control software on the rationality of TPN. METHODS Based on the hospital information system （HIS） , pharmacists and information technology professionals joint-developed a suitable TPN control software for the use of tumor hospital, and by retrospective study, a total of 387 patients with colorectal cancer surgery in our hospital in 2015 two quarter and four quarter were collected, including TPN control software before the application of 200 cases, after the application of 187 cases. Excel table data automatic screening, classification and summary were used, and then SPSS 20.0 statistical software analysis was used to evaluate the effect of clinical application of TPN control software by pharmacists in our hospital on the rationality of TPN. RESULTS TPN control software could manage the range of the total heat, glycolipid ratio, the ratio of heat to nitrogen, liquid volume, electrolytes and other indexes of which. Before and after the TPN control software intervention, there were no statistically significant differences in gender, age, type of disease, PS score and BMI index in these colorectal cancer patients （ P 〉 0.05 ）, but there were significant differences in total heat,electrolyte concentrations, glycolipid ratio, the ratio of heat to ni- trogen and the rationality of the use of glutamine （P 〈 0. 05）. CONCLUSION The clinical application of TPN control software in cancer specialized hospital has improved the rationality of TPN order and reflects the role and value of pharmacists.

关 键 词：TPN管控软件 结直肠癌 术后 合理性 

分 类 号：R735.34[医药卫生—肿瘤]