某院重症住院患者静脉输液的用药情况分析  

Medication analysis of intravenous infusion in critically ill patients in a hospital

作　　者：曾双双[1,2,3] 陈曦 刘万里 尹桃[1,2,3] 龚志成[1,2,3] ZENG Shuang-shuang;CHEN Xi;LIU Wan-li;YIN Tao;GONG Zhi-cheng(Department of Pharmacy,Xiangya Hospital,Central South University,Hunan Changsha 410008,China;Institute of Hospital Pharmacy,Central South University,H unan Changsha 410008,China;Nursing Department,Xiangya Hospital,Central South University,Hunan Changsha 410008,China;National Clinical Research Center for Geriatric Disorders（Xiangya）,Hunan Changsha 410008,China)

机构地区：[1]中南大学湘雅医院药学部,湖南长沙410008 [2]中南大学医院药学研究所,湖南长沙410008 [3]国家老年疾病临床医学研究中心<湘雅>,湖南长沙410008 [4]中南大学湘雅医院护理部,湖南长沙410008

出　　处：《中国医院药学杂志》2018年第16期1750-1754,共5页Chinese Journal of Hospital Pharmacy

基　　金：中南大学临床大数据系统建设项目(46号);中南大学湘雅医院医院管理研究基金(2016GL21);湖南省财政厅项目(湘财社指[2016]129号)

摘　　要：目的:探讨某综合三甲医院重症住院患者使用静脉输液的概况和合理性。方法:回顾调查2015年7月-2016年6月重症监护病房(ICU)住院患者输液的情况,对基本信息、费用、诊断、输液药品等数据进行统计,并根据说明书和文献分析溶媒和配伍的不合理情况。结果:6 427人次输液的ICU患者中,平均每人次住院输液23.95组(平均60.85瓶),输液平均疗程4.89 d,中心ICU最多(37.45%),脑出血、心脏病、肺癌患者较多,治愈好转率90.30%。用量较大的输液药品中依达拉奉针、复方氯化钠注射液及氯化钾针等药物在使用过程中发生的溶媒、配伍不合理问题较多。存在复方麝香注射液(不合理比例79.07%)、脱氧核苷酸钠针(66.67%)、小牛血清去蛋白注射液(58.25%)等不宜与其他药物混合输注的小支针剂仍与其他药物混合配伍使用的不合理情况。结论:研究表明重症住院患者中输液治疗应用广泛,但在溶媒、配伍方面存在较多不合理问题,管控措施应重点关注这部分常见不合理的输液药物,拟构建监控预警系统和全面评估体系进行输液管理,以落实合理用药要求。OBJECTIVE To explore the profile and rationality of intravenous infusion in critically ill patients in a tertiary A hospital.METHODS The situations of patients in intensive care unit（ICU）were reviewed for intravenous infusion from July2015 to June 2016,and basic information,costs,diagnosis of disease and infusion drugs were summarized.According to drug labels and articles,irrationality of solvents and compatibility were analyzed.RESULTS A total of 6 427 patients were enrolled,transfused with23.95 sets（average 60.85 bottles）in an average transfusion cycle of about 4.89 days.Most patients were diagnosed with cerebral hemorrhage,heart disease or lung cancer,and about 90.30% patients were cured or improved,mainly admitted in ICU（37.45%）.Of infusion drugs used in large amounts,edaravone injection,Ringer solution and potassium chloride injection showed relatively more problems such as unreasonable solvent and drug incompatibility.Injections not suitable to mix with other drugs in the same infusion,including compound musk injections（79.07%irrational rate）,deoxyribonucleotide injections（66.67%）,and deproteinised calf blood serum injection（58.25%）,were still inappropriately mixed with other drugs.CONCLUSION This study demonstrates that infusion therapy is widely used in critically ill patients in this hospital.However,there are many inappropriate use problems of intravenous infusion including inappropriate solvent and drug incompatibility.More attentions should be paid to these infusion drugs with more common inappropriate issues.This hospital is intended to build the monitoring and pre-warning system and comprehensive assessment system for infusions to carry out hospital infusion management and implement requirements for rational use of drugs.

关 键 词：重症监护病房 静脉输液 合理用药 溶媒 配伍 

分 类 号：R969.3[医药卫生—药理学]