肠外营养集中管理对处方合理性及胃肠道肿瘤患者临床结局的影响  

Effect of PN centralized management mode on the rationality of PN prescription and clinical outcome in patients with gastrointestinal tumor surgery

作　　者：刘彦 刘海珍[1] 宋桂花[1] 王然[1] 张明[2] 杨燕萍[1] LIU Yan;LIU Haizhen;SONG Guihua;WANG Ran;ZHANG Ming;YANG Yanping(Department of Clinical Nutrition,Weifang People′s Hospital,Weifang 261041,China;Department of Nutrition,Peking University Shenzhen Hospital)

机构地区：[1]潍坊市人民医院临床营养科,山东潍坊261041 [2]北京大学深圳医院营养科

出　　处：《潍坊医学院学报》2022年第1期15-17,共3页Acta Academiae Medicinae Weifang

基　　金：潍坊市三甲医院胃肠道大手术营养风险、营养支持应用和结局以及成本效益分析研究(项目编号:2011HD018)。

摘　　要：目的 分析我院肠外营养集中管理后,肠外营养处方合理性和胃肠道肿瘤手术患者临床结局的变化。方法 选取2017年上半年和2018年上半年就诊于我院并行胃肠道肿瘤手术且应用肠外营养治疗的患者。统计其肠外营养处方热氮比、糖脂比、阳离子浓度及患者住院时间、药占比、肠外营养(PN)费用占比、总住院费用、并发症发生率等。分析肠外营养集中管理前后处方合理率、患者住院天数、住院总费用及并发症发生率的变化。结果 肠外营养集中管理后,PN输注形式发生了改变,肠外营养处方个体化配制比例增加(P<0.001);PN处方热氮比、糖脂比、阳离子浓度不合理比例下降(均有P<0.05),不合理应用谷氨酰胺及磷制剂的比例降低(P<0.05)。PN费用占比、药占比均较前下降(P<0.001)。结论 肠外营养集中管理有利于规范PN处方合理性,改善患者临床结局。Objective To analyze the rationality of parenteral nutrition prescription and the changes of clinical outcomes of patients with gastrointestinal tumor surgery before and after the PN centralized management mode.Methods The patients who underwent gastrointestinal tumor surgery and received parenteral nutrition therapy in our hospital in the first half of 2017 and 2018 were retrospectively selected.The ratio of heat to nitrogen, the ratio of sugar to lipid, the concentration of cation, the length of hospital stay, the proportion of drugs cost, the proportion of PN,the total hospitalization expenses and the incidence of complications were statistically analyzed.The changes of reasonable rate of parenteral nutrition prescription, length of hospital stay, total cost of hospitalization and incidence of complications before and after PN centralized management were analyzed.Results After the application of PN centralized management mode, the infusion form of PN changed.At the same time, the proportion of individualized parenteral nutrition prescriptions increased(P<0.001).The irrational ratios of the ratio of heat to nitrogen, the ratio of sugar to lipid and cation concentration in PN prescription decreased.Compared with before intervention, the proportion of PN cost and drugs cost decreased.Conclusion PN centralized management mode is conducive to standardize PN prescription and improve the clinical outcome of patients.

关 键 词：临床营养科 肠外营养 胃肠道肿瘤 

分 类 号：R459.3[医药卫生—治疗学]