药物混合调配技术对成品输液中不溶性微粒的控制情况分析  

Analysis of the Control of Insoluble Particles in the Finished Infusion by Drug Mixing and Blending Technology

作　　者：李霞 古云 张海 鲁晓男 汪清桂 杨枫 寸润樱 LI Xia;GU Yun;ZHANG Hai;LU Xiao-nan;WANG Qing-gui;YANG Feng;CUN Run-ying(Intravenous Medicine Dispensing Center,the First Affiliated Hospital of Dali University,Dali,Yunnan Province,671000 China)

机构地区：[1]云南省大理大学第一附属医院静脉用药调配中心,云南大理671000

出　　处：《系统医学》2020年第20期140-143,共4页Systems Medicine

基　　金：大理大学青年教师科研基金项目(KYQN201613)。

摘　　要：目的分析在PIVAS的药物集中混合调配过程中容易发生微粒污染的相关环节,规范药物混合调配的无菌操作技术,达到预防或减少微粒污染的目的。方法2018年1—6月针对不同配伍的药品及溶媒,通过对照实验方法进行统计分析输液微粒污染的影响因素。结果对于0.9%氯化钠注射液,≥10μm、≥25μm的微粒数是3个/mL、0.3个/mL;对于5%葡萄糖注射液,≥10μm、≥25μm的微粒数是0.6个/mL、0.1个/mL。维生素C注射液与溶媒配伍后,玻璃安瓿切割1/4周产生的微粒数最少,≥10μm、≥25μm的微粒数是5.82个/mL、0.55个/mL,不切割产生的微粒数最多,≥10μm、≥25μm的微粒数是7.21个/mL、1.1个/mL。维生素C注射液与溶媒配伍后,选用溶药针头规格1.2 mm产生的微粒数(≥10μm、≥25μm的微粒数是3.75个/mL、0.32个/mL)比1.6 mm的(≥10μm、≥25μm的微粒数是5.82个/mL、0.55个/mL)要少。维生素C注射液与溶媒配伍后,注射器使用45°斜形方式穿刺进入溶媒产生的微粒(≥10μm、≥25μm的微粒数是2.51个/mL、0.05个/mL)比垂直方式进入的微粒数(≥10μm、≥25μm的微粒数是3.75个/mL、0.32个/mL)要少。注射用头孢唑啉钠与溶媒预溶后,注射器穿刺1次产生的微粒数(≥10μm、≥25μm的微粒数是9.67个/mL、0.94个/mL)明显比穿刺2次的微粒数(≥10μm、≥25μm的微粒数是15.41个/mL、1.89个/mL)少。结论选择最合适的器材,规范的药物混合调配技术,能够达到预防或减少微粒的污染,保障患者用药安全的目的。Objective To analyze the related links that are prone to particle contamination during the concentrated mixing and dispensing of PIVAS drugs,and to standardize the aseptic operation techniques of drug mixing and dispensing to achieve the purpose of preventing or reducing particulate pollution.Methods According to different compatible drugs and solvents,the influencing factors of infusion particulate pollution were statistically analyzed by comparative experimental methods from January to June 2018.Results For 0.9%sodiμm chloride injection,the number of particles≥10μm and≥25μm were 3 pcs/mL and 0.3 pcs/mL;for 5%glucose injection,the number of particles≥10μm and≥25μm were 0.6 pcs/mL,0.1 pcs/mL.After vitamin C injection and solvent were combined,the number of particles produced by glass ampoules after 1/4 week was the least,the number of particles≥10μm and≥25μm are 5.82 pcs/mL and 0.55 pcs/mL,and the number of particles without cutting was the most,≥10μm and≥25μm were 7.21 pcs/mL and 1.1 pcs/mL.After vitamin C injection was compatible with the solvent,the number of particles produced by the 1.2 mm size of the dissolving needle(the number of particles≥10μm,≥25μm were 3.75 pcs/mL,0.32 pcs/mL)than 1.6 mm(≥10μm,≥25μm were 5.82 pcs/mL,0.55 pcs/mL).After the vitamin C injection is compatible with the solvent,the particles produced by the syringe piercing into the solvent using a 45°oblique method(the number of particles≥10μm,≥25μm were 2.51 pcs/mL,0.05 pcs/mL)than the number of particles entering the vertical method(the number of particles≥10μm and≥25μm were 3.75 pcs/mL,0.32 pcs/mL).After the cefazolin sodiμm for injection is pre-dissolved with the solvent,the number of particles produced by one syringe puncture(the number of particles≥10μm,≥25μm were 9.67 pcs/mL,0.94 pcs/mL)was significantly higher than the number of particles produced by two punctures(≥10μm The number of particles≥25μm were 15.41 pcs/mL,1.89 pcs/mL).Conclusion Choosing the most suitable equi

关 键 词：药物混合调配技术 不溶性微粒 控制 情况分析 

分 类 号：R95[医药卫生—药学]