全肠外营养处方分析  

Analysis of prescription of total intravenous nutrition

作　　者：许燕红[1] 罗威[1] 梁文焕[1] 吴志文[1] 王国乐 吴子贵[1] 李华驹 XU Yan-hong;LUO Wei;LIANG Wen-huan(Fifth Affiliated（Zhuhai）Hospital of Zunyi Medical College,Zhuhai 519100,China)

机构地区：[1]遵义医学院第五附属(珠海)医院,519100

出　　处：《中国现代药物应用》2018年第12期209-211,共3页Chinese Journal of Modern Drug Application

摘　　要：目的分析本院全肠外营养(TPN)处方的使用情况与存在的问题,提高全肠外营养药物治疗的安全性、有效性。方法对本院1069张医嘱TPN处方进行分析,统计TPN处方数量、不合格处方数量,并按溶媒选择、配伍禁忌、用药频率、用药剂量、药物浓度、静脉营养液等主要项目对不合理处方进行回顾性分析。结果 (1)1069张TPN处方,其中肿瘤科248张(23.20%)、普外科232张(21.70%)、特需病房[包括重症加强护理病房(ICU)及急诊综合病房]252张(23.57%),整形烧死外科47张(4.40%),心胸外科191张(17.87%)、血液肿瘤科99张(9.26%)。(2)1069张TPN处方中不合理处方63张,占所有处方的5.89%;其中用法用量不合理24张(38.10%),溶媒选择不当17张(26.98%),载体量选择不当13张(20.63%),药物配伍禁忌9张(14.29%)。用法用量不合理处方中,糖脂比不合理处方9张(37.50%),热氮比不合理处方6张(25.00%),电解质用量不合理处方5张(20.83%),维生素用量不合理处方3张(12.50%),丙氨酰-谷氨酰胺用量不合理处方1张(4.17%);溶媒选择不合理处方中,中成药溶媒处方7张(41.18%),抗生素溶媒处方5张(29.41%),其他药物溶媒处方5张(29.41%)。结论 TPN不合理处方主要以用法用量不合理为主,需要引起高度重视,加强监督,保障患者的用药安全、有效。Objective To analyze the usage and problems of total parenteral nutrition（TPN） prescription in our hospital, so as to improve the safety and efficacy of total intravenous nutrition. Methods The TPN prescription of 1069 medical orders in our hospital was analyzed. The number of TPN prescriptions and the number of unqualified prescriptions were counted, and the irrational prescriptions were retrospectively analyzed based on solvent selection, incompatibility, frequency of medication, dosage, drug concentration, and intravenous nutrient solution. Results（1） Among 1069 TPN prescriptions, there were 248 oncology prescriptions（23.20%）, 232 general surgery prescriptions（21.70%）, 252 special needs wards prescriptions（23.57%）（including intensive care unit（ICU） and emergency comprehensive wards）, 47 plastic burn surgery prescriptions（4.40%）, 191 cardiac and thoracic surgery prescriptions（17.87%）, and 99 oncology prescriptions（9.26%）.（2） There were 63 irrational prescriptions in 1069 TPN prescriptions, accounting for 5.89% of all prescriptions, including 24 prescriptions of irrational usage and dosage（38.10%）, 17 prescriptions of improperly selected solvent（26.98%）, 13 prescriptions of improperly selected vector quantity（20.63%）, 7 prescriptions of drug incompatibility（14.29%）. In prescriptions of irrational usage and dosage, there were 9 prescriptions（37.50%） for unreasonable sugar/lipid ratio, 6 prescriptions（25.00%） for unreasonable hot nitrogen ratio, 5 prescriptions（20.83%） for unreasonable electrolyte usage, and 3 prescriptions（12.50%） for unreasonable vitamin usage, and 1 prescription（4.17%） for unreasonable amount of alanyl-glutamine. In prescriptions of improperly selected solvent, there were 7 solvent prescriptions（41.18%） for Chinese patent medicine, 5 solvent prescriptions（29.41%） for antibiotics, and 5 solvent prescriptions（29.41%） for other drugs. Conclusion The irrational prescriptions of TPN are mainly unreasonable in

关 键 词：全肠外营养 住院患者 处方 

分 类 号：R95[医药卫生—药学]