江苏省12家医院肠外营养制剂使用现状调研  

Investigation on the utilization of parenteral nutrition preparations in 12 Hospitals of Jiangsu

作　　者：刘金春[1] 陈大宇 卞晓洁[1] 游一中[2] 陈霞[3] 蔡萍 吕冬梅 胡森 庞洁 葛卫红[1] Liu Jinchun;Chen Dayu;Bian Xiaojie;You Yizhong;Chen Xia;Cai Ping;Lv Dongmei;Hu Miao;Pang Jie;Ge Weihong(Department of Pharmacy,the Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院药学部,210008 [2]常州市第一人民医院 [3]南通市第一人民医院 [4]扬州大学附属医院 [5]徐州医科大学附属医院 [6]南京医科大学附属第二医院 [7]连云港市第一人民医院

出　　处：《中华临床营养杂志》2019年第3期144-148,共5页Chinese Journal of Clinical Nutrition

基　　金：江苏省医保研究会项目(JSYB2017002).

摘　　要：目的调研江苏省内肠外营养制剂使用现状,为肠外营养制剂的规范管理提供参考依据。方法抽取江苏省内12家医院2017年1月至2017年6月普外科使用肠外营养制剂的患者720例,对患者入院营养风险筛查率、肠外营养使用适应证、输注途径、组方合理性及经济性进行回顾性评价。对于使用全合一肠外营养三升袋的患者,计算热卡、氨基酸量、非蛋白热氮比值、糖脂比、阳离子浓度。结果12家医院720份病例使用肠外营养制剂总金额161.41万元,其中346份病例无肠外营养制剂使用适应证。处方点评结果表明,只有16份病例在入院时使用营养风险筛查2002(NRS2002)工具对患者进行了营养风险筛查。544份病例为外周静脉单瓶静脉滴注氨基酸和脂肪乳。176份全合一肠外营养三升袋中,39份非蛋白热氮比值、15份糖脂比、69份阳离子浓度、61份热卡、32份氨基酸量不符合指南推荐,仅有31份三升袋完全符合指南组方要求。结论江苏省内各家医院肠外营养制剂使用金额高,但合理率低。应成立营养支持小组(NTS),规范肠外营养制剂的使用,节约医疗资源。Objective To investigate the use of parenteral nutrition preparations in Jiangsu Province, and to provide reference for the standardized management of parenteral nutrition preparations. Methods 720 cases using parenteral nutrition preparations from January 2017 to June 2017 in the department of general surgery of 12 hospitals in Jiangsu province were selected. The rate of nutritional risk screening ,the indications of parenteral nutrition, the way of infusion , the rationality and economy of the prescriptions were retrospectively evaluated. The calorie, amino acid content, non-protein calorie/nitrogen ratio, glycolipid ratio and cation concentration of the patients received total parenteral nutrition were calculated. Results The total costs of parenteral nutrition preparations of 720 cases were 1. 614 1 millions, and 346 cases did not have the indications for parenteral nutrition. The results of prescription comment showed that only 16 patients were screened for nutritional risk by Nutritional Risk Screening 2002 tool at admission. 544 cases were intravenous dripped with amino acid and fat emulsion from peripheral vein. In the 176 total parenteral nutrition prescriptions, there were 39 non-protein calorie/nitrogen ratio cases, 15 glycolipid ratio cases, 69 cation concentration cases, 61 calorie cases and 32 amino acid content cases failing to comply with the recommendation of the guidelines. Only 31 total parenteral nutrition prescriptions were completely reasonable. Conclusion The costs of parenteral nutrition preparations used in hospitals of Jiangsu are high but the rate of rationality is low. Nutrition support team should be established to regulate the use of parenteral nutrition preparations and save medical resources.

关 键 词：肠外营养 NRS2002 营养风险筛查 营养支持小组 

分 类 号：R459.3[医药卫生—治疗学]