上海市某三级综合性医院肠外营养使用合理性分析  

Rationality analysis of parenteral nutrition in a tertiary general hospital in Shanghai

作　　者：赵琼玥 曹莹 姚囡囡 赵宇晗 顾董事 谢铭 徐福建 ZHAO Qiongyue;CAO Ying;YAO Nannan;ZHAO Yuhan;GU Dongshi;XIE Ming;XU Fujian(Department of Pharmacy,Jinshan Hospital Affiliated to Fudan University,Shanghai 201500,China;不详)

机构地区：[1]复旦大学附属金山医院药剂科,上海201500 [2]遵义医科大学附属医院胃肠外科,贵州遵义563000

出　　处：《山东医药》2025年第2期70-74,共5页Shandong Medical Journal

摘　　要：目的分析上海市某三级综合性医院肠外营养使用的合理性,为临床规范应用肠外营养提供参考。方法在医院病历系统中收集上海市某三级综合性医院2023年1月—2024年1月应用肠外营养治疗的821例患者的病历资料,基于肠外营养各指南建议,综合患者饮食情况、营养状况、临床诊断及实验室检查结果,分析肠外营养使用的合理性。结果821例患者中,存在肠外营养使用不合理192例(23.51%),主要涉及的项目包括无营养筛查181例(22.00%)、给药方式不适宜96例(11.10%)、总能量不足87例(10.60%)、糖脂比超范围116例(14.13%)等。结论上海市某三级综合性医院肠外营养使用不合理情况较多,主要包括无营养筛查、给药方式不适宜、总能量不足、糖脂比超范围等。临床应用肠外营养时,应完善肠外营养诊治流程,提高临床医生对肠外营养的认知水平,同时加强营养科、药剂科等相关科室的审核与干预。Objective To analyze the rationality of parenteral nutrition(PN)used in a tertiary general hospital in Shanghai and to provide reference for clinical rational use of PN.Methods The medical records of 821 patients who used PN in a tertiary general hospital in Shanghai from January 2023 to January 2024 were selected through the hospital medical record system.According to the recommendations of the guidelines of PN,the rationality of the use of PN in each patient was retrospectively analyzed according to the diet,nutritional status,clinical diagnosis and laboratory examination results.Results Among the 821 PN medical records,there were 192 cases of unreasonable PN use,with an unreason able rate of 23.51%.The main unreasonable items were non-nutritional risk screening of 181 cases(22.00%),inappro priate drug administration of 96 cases(11.10%),total energy shortage of 87 cases(10.60%),and glucose-to-lipid ratio exceeding the recommended range of 116 cases(14.13%),etc.Conclusions The rate of unreasonable use of PN in this tertiary general hospital in Shanghai is high,and the main unreasonable items are non-nutritional risk screening,inap propriate drug administration,total energy shortage,and glucose-to-lipid ratio exceeding the recommended range,etc.When using PN in clinic,the treatment process should be improved,the clinicians'understanding of PN and the examina tion and intervention of nutrition department,pharmacy department and other related departments should be strengthened.

关 键 词：肠外营养 肠外营养处方 营养筛查 处方分析 

分 类 号：R459.3[医药卫生—治疗学]