基于加权逼近理想解排序法的肠外营养用药合理性评价  

Evaluation of rationality of parenteral nutrition based on TOPSIS

作　　者：赵晓晓[1] 刘智化 祝子明 李海霞 宁丽娟 ZHAO Xiao-xiao;LIU Zhi-hua;ZHU Zi-ming;LI Hai-xia;NING Li-juan(The Affiliated Xuancheng Hospital of Wannan Medical College,Xuancheng Anhui 242000;Department of Pharmacy,The First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital),Hefei 230001)

机构地区：[1]皖南医学院附属宣城医院,安徽宣城242000 [2]中国科学技术大学附属第一医院药剂科,合肥230001

出　　处：《中南药学》2025年第4期1160-1163,共4页Central South Pharmacy

基　　金：宣城市卫生健康科研项目(No.XCWJ2023011)。

摘　　要：目的评价某院2023年重症医学科全年肠外营养(PN)医嘱,并对其合理性进行分析。方法制订PN医嘱评价细则,采用加权逼近理想解排序(TOPSIS)法对该院PN病历进行合理性评价。结果227份病历中,C_(i)最高为100.00%,最低为46.82%。C_(i)为100.00%的43例(18.94%),80%≤C_(i)<90%的49例(21.59%),70%≤C_(i)<80%的63例(27.75%),60%≤C_(i)<70%的61例(26.87%),<60%的11例(4.85%)。不合理用药主要表现在PN中添加未经验证相容性的药物179例(78.85%)、多种微量元素剂量不达标94例(41.41%)、非蛋白热氮比不合理63例(27.75%)、丙氨酰谷氨酰胺占全部氨基酸占比34例(14.98%)、存在禁忌证用药17例(7.49%)、遴选药品的适宜性不合理15例(6.61%)、糖脂比不适宜14例(6.17%)。结论基于加权TOPSIS法实施PN点评较为科学,该院PN医嘱的临床应用基本合理,但仍需加强管控。Objective To evaluate the annual order of parenteral nutrition(PD)in intensive care department of a hospital in 2023 and determine its rationality.Methods The evaluation criteria of parenteral nutrition(PN)medical orders were established,and the rationality of PN medical order was evaluated by weighted approaching ideal solution ranking(TOPSIS).Results The highest C_(i) was 100.00%and the lowest C_(i) was 46.82%in 227 records.Totally 43 cases(18.94%)had C_(i) 100.00%,49 cases(21.59%)had 80%≤C_(i)<90%,63 cases(27.75%)70%≤C_(i)<80%,61 cases(26.87%)60%≤C_(i)<70%,and 11 cases(4.85%)<60%.The main manifestations of irrational drug use included addition of drugs without proven compatibility in PN[179 cases(78.85%)],dose of various trace elements failing to reach the standard[94 cases(41.41%)],unreasonable non-protein heat nitrogen ratio[63 cases(27.75%)],alanyl glutamine accounting for the total amino end[34 cases(14.98%)],and contraindications 17 cases(7.49%).The suitability of selected drugs was not reasonable in 15 cases(6.61%),and the ratio of sugar to lipid was in appropriate in 14 cases(6.17%).Conclusion The evaluation of PN use based on weighted TOPSIS method is scientific,and the PN medical orders in this hospital is basically reasonable.

关 键 词：加权逼近理想解排序法 肠外营养 用药合理性评价 

分 类 号：R96[医药卫生—药理学] R95[医药卫生—药学]