郑州某三甲医院成人住院患者肠外营养治疗的现状调查:一项回顾性横断面研究  

Investigation on the parenteral nutrition therapy in hospitalized adult patients in a tertiary hospital of Zhengzhou:A retrospective cross-sectional study

作　　者：祁献芳[1] 王志 何丹丹 温晓龙 张磊[1] 孙俊[1] QI Xianfang;WANG Zhi;HE Dandan;WEN Xiaolong;ZHANG Lei;SUN Jun(Department of Pharmacy,People's Hospital of Henan Province,Henan Zhengzhou 450003,China;Department of Pharmacy,The Ninth People's Hospital of Zhengzhou City,Henan Zhengzhou 450053,China;Department of Pharmacy,Xincai People's Hospital,Henan Zhumadian 463500,China;Department of Pharmacy,Jizhong Energy Xingtai Mining Group General Hospital,Hebei Xingtai 054000,China)

机构地区：[1]河南省人民医院药学部,河南郑州450003 [2]郑州市第九人民医院药剂科,河南郑州450053 [3]新蔡县人民医院药剂科,河南驻马店463500 [4]冀中能源邢矿集团总医院药剂科,河北邢台054000

出　　处：《中国医院药学杂志》2023年第12期1402-1405,共4页Chinese Journal of Hospital Pharmacy

基　　金：河南省科技攻关项目(编号:222102310126)。

摘　　要：目的:调查郑州某三甲医院成人住院患者肠外营养(PN)治疗的现状和特点,为临床合理用药提供参考。方法:对2020年1月至2020年12月河南省人民医院PN治疗的成人住院患者进行回顾性研究,分析PN治疗的方式和全营养混合液(TNA)处方营养成分,评估TNA处方的合理性和营养支持小组(NST)的作用。结果:共纳入51 745例患者。PN治疗方式上,多瓶串输占89.4%。与工业化多腔袋相比,自配TNA的液体量、热量、宏量营养素、糖脂比和热氮比高,添加药理营养素和微量营养素的频率高(P<0.001)。TNA处方的不合理率34.8%,工业化多腔袋与自配TNA的处方合理性差异无统计学意义(P=0.844),但使用工业化多腔袋能够提高处方的稳定性与相容性。NST参与会诊显著提高了TNA处方的合理性(93.4%vs.47.9%,P<0.001)。结论:在临床实践中,PN治疗的不合理问题较多,应充分发挥NST的作用,提高临床营养治疗的安全性、有效性和经济性。OBJECTIVE To investigate the current practice and characteristics of PN therapy in hospitalized adult patients in a tertiary hospital of Zhengzhou,in order to provide references for clinical rational use of drugs.METHODS This study was conducted retrospectively for the adult patients who were hospitalized and received PN therapy in People’s Hospital of Henan Province on January 2020 to December 2020.We analyzed the type of PN therapy and the nutritional composition of TNA prescriptions,and evaluated the rationality of TNA prescriptions and the role of NST.RESULTS A total of 51745 patients were included.In terms of infusion,multi-bottle serial infusion accounted for 89.4%.Compared with multi-chamber bag,compounded TNA had a higher supply of volume,total calories,macronutrients,carbohydrate-to-lipid ratio and nonprotein calories-to-nitrogen ratio,a higher frequency of pharmaconutrients and micronutrients added to the bag(P<0.001).The irrational rate of TNA prescriptions was 34.8%,there was no significant difference on the rationality of prescriptions between multi-chamber bag and compounded TNA(P=0.844),but the stability and compatibility of prescriptions could be improved by using multi-chamber bag.The rationality of TNA prescriptions(93.4%vs.47.9%,P<0.001)could be significantly improved by the participation of NST.CONCLUSION There are many problems with the PN therapy in clinical practice.It is necessary to give full play to the role of NST to improve the safety,effectiveness and economy of clinical nutrition treatment.

关 键 词：肠外营养 全营养混合液 营养成分 处方分析 

分 类 号：R969.4[医药卫生—药理学]