复方氨基酸注射液(18AA-V-SF)住院医嘱专项点评分析  

Special Comments on Inpatient Orders of Compound Amino Acid Injection(18AA-V-SF)

作　　者：张卿 张攀 杨雪 幸海燕 ZHANG Qing;ZHANG Pan;YANG Xue;XING Haiyan(Department of Pharmacy,Daping Hospital,Army Medical University,Chongqing,China 400042)

机构地区：[1]中国人民解放军陆军军医大学大坪医院药剂科,重庆400042

出　　处：《中国药业》2022年第21期107-110,共4页China Pharmaceuticals

基　　金：重庆市首批临床药学重点专科建设项目[渝卫办发[2020]68号];中国人民解放军陆军特色医学中心人才创新能力培养计划[2019CXLCC013,2019CXJXC017]。

摘　　要：目的促进重点监控药物复方氨基酸注射液(18AA-V-SF)的临床合理、规范应用。方法临床药师从医院药品上市后安全性研究(PASS)临床药学管理系统随机抽取2020年12月(干预前)和2021年9月(干预后)使用复方氨基酸注射液(18AA-V-SF)作为全合一肠外营养成分的住院医嘱各300条,根据相关共识及药品说明书对其进行专项点评,参数包括非蛋白热氮比,氨基酸浓度,谷氨酰胺占比,一价、二价阳离子浓度,以及使用复方氨基酸注射液(18AA-V-SF)作为全合一肠外营养成分的住院医嘱的应用率。结果干预后,使用复方氨基酸注射液(18AA-V-SF)的非蛋白热氮比偏高3个程度(>200∶1,>400∶1,>600∶1)的住院医嘱不合理率分别为12.33%,3.33%,0,分别显著低于干预前的23.00%,7.33%,3.33%(P<0.05);干预后,氨基酸浓度偏低3个程度(<1.50%,<1.94%,<2.50%)的住院医嘱不合理率分别为6.33%,10.67%,11.67%,分别显著低于干预前的17.33%,21.33%,24.67%(P<0.05);干预后,谷氨酰胺占比4.33%,低于干预前的5.33%,但差异不显著(χ^(2)=0.33,P>0.05);干预前后,使用该氨基酸的肠外营养液中二价阳离子浓度均未超过限量;干预后,一价阳离子浓度超过限量的占0.67%,低于干预前的2.33%,但差异不显著(χ^(2)=2.82,P>0.05)。干预后,应用率为15.33%,显著低于干预前的29.33%(P<0.05)。结论临床药师针对医院用量异常增长的重点监控药物复方氨基酸注射液(18AA-V-SF)进行专项点评干预,可提高其临床应用的合理性。Objective To promote the rational and standardized application of the key monitored drug of Compound Amino Acid Injection(18AA-V-SF)in the clinic.Methods The inpatient orders of using the Compound Amino Acid Injection(18AA-V-SF)as a composition of all-in-one total parenteral nutrition(TPN)from the PASS Pharm Assist in December 2020(before the intervention)and September 2021(after the intervention)were randomly selected by the clinical pharmacists,with 300 inpatient orders in each time point.The above inpatient orders were made special comments according to the relevant consensuses and drug instructions,and the parameters of comments included the ratio of non-protein calories to nitrogen,the concentration of amino acids,the proportion of glutamine,the concentrations of monovalent and divalent cations,the application rate of inpatient orders using the Compound Amino Acid Injection(18AA-V-SF)as a composition of all-in-one TPN.Results After the intervention,the unreasonable rates of inpatient orders in the three levels with higher ratios of non-protein calories to nitrogen(>200∶1,>400∶1 and>600∶1)using the Compound Amino Acid Injection(18AA-V-SF)were 12.33%,3.33%and 0 respectively,which were significantly lower than 23.00%,7.33%and 3.33%before the intervention(P<0.05).After the intervention,the unreasonable rates of inpatient orders in the three levels with lower concentrations of amino acids(<1.50%,<1.94%and<2.50%)using the Compound Amino Acid Injection(18AA-V-SF)were 6.33%,10.67%and 11.67%respectively,which were significantly lower than 17.33%,21.33%and 24.67%before the intervention(P<0.05).After the intervention,the proportion of glutamine was 4.33%,which was lower than 5.33%before the intervention,without significant difference(χ^(2)=0.33,P>0.05).Before and after the intervention,the concentration of divalent cations in TPN solution using the amino acids was not over the limit.After the intervention,the proportion of monovalent cation concentration in the TPN solution over the limit was 0.67%,which was low

关 键 词：复方氨基酸注射液(18AA-V-SF) 住院医嘱 专项点评 重点监控药物 

分 类 号：R95[医药卫生—药学]