某院肠外营养处方分析  

Parenteral Nutrition Prescription in a Hospital

作　　者：林洪 秦舟[1] 代国友[1] 陈昭阳 邹敏[1] 巫尹涛[1] 徐珽[1,3] 何治尧 LIN Hong;QIN Zhou;DAI Guoyou;CHEN Zhaoyang;ZOU Min;WU Yintao;XU Ting;HE Zhiyao(Department of Clinical Pharmacy,West China Hospital,Sichuan University,Chengdu,Sichuan,China 610041;School of Clinical Medicine,Sichuan College of Traditional Chinese Medicine,Mianyang,Sichuan,China 621000;West China School of Pharmacy,Sichuan University,Chengdu,Sichuan,China 610041)

机构地区：[1]四川大学华西医院临床药学部,四川成都610041 [2]四川中医药高等专科学校临床医学院,四川绵阳621000 [3]四川大学华西药学院,四川成都610041

出　　处：《中国药业》2022年第7期112-116,共5页China Pharmaceuticals

基　　金：国家自然科学基金[81602699];四川大学华西医院学科卓越发展1·3·5工程项目[ZYJC18028]。

摘　　要：目的规范肠外营养处方的组分配伍和营养支持方案。方法采用回顾性研究方法,通过医院信息系统随机抽取2020年7月至12月某院肠外营养处方,从配伍稳定性、营养素配比、临床诊断和渗透压4个方面评价其合理性。结果共抽取785张处方,有效处方775张,有效率为98.73%。处方不合理评价项中,不合理占比排名前3的分别为热氮比(24.77%,192/775),糖脂比(17.42%,135/775),丙氨酰谷氨酰胺浓度(5.68%,44/775);其次为氨基酸浓度(2.06%,16/775),葡萄糖浓度(1.42%,11/775),二价阳离子浓度(0.90%,7/775);未见配伍禁忌、胰岛素、药物选择与临床诊断不合理处方。结论该院肠外营养处方在配伍稳定性、营养素配比、渗透压方面均存在不合理现象,临床诊断全部合理。药师应加强与临床医师、护士、营养师的沟通,应严格按规范审核肠外营养处方;医院应定期组织肠外营养与临床医学知识的培训,保障肠外营养的合理使用。Objective To standardize the ingredient compatibility and nutritional support scheme of parenteral nutrition prescription.Methods Retrospective research method was conducted,the parenteral nutrition prescriptions of the hospital from July to December 2020 were randomly selected through the hospital information system(HIS),and the rationality was evaluated from four aspects:compatibility stability,nutrient ratio,clinical diagnosis and osmotic pressure.Results A total of 785 prescriptions were selected,775 of which were effective,and the effective rate was 98.73%.Among the unreasonable evaluation items of prescriptions,the top three unreasonable proportions were the ratio of energy to nitrogen(24.77%,192/775),the ratio of glycolipid(17.42%,135/775)and alanyl-glutamine concentration(5.68%,44/775),followed by amino acid concentration(2.06%,16/775),glucose concentration(1.42%,11/775),divalent cation concentration(0.90%,7/775),and no incompatibility,insulin,drug selection and unreasonable prescription of clinical diagnosis were found.Conclusion The prescription of parenteral nutrition in this hospital is unreasonable in compatibility stability,nutrient ratio and osmotic pressure,and the clinical diagnosis is all reasonable.Pharmacists should strengthen communication with clinicians,nurses and nutritionists,and audit parenteral nutrition prescriptions in strict accordance with standards.Hospitals should regularly organize training on parenteral nutrition and clinical medical knowledge to ensure the rational use of parenteral nutrition.

关 键 词：肠外营养 处方分析 配伍稳定性 营养素配比 渗透压 合理用药 

分 类 号：R95[医药卫生—药学]