中国药师
中國藥師
중국약사
CHINA PHARMACIST
2015年
5期
833-835
,共3页
全肠外营养%使用情况分析%营养素%临床药师
全腸外營養%使用情況分析%營養素%臨床藥師
전장외영양%사용정황분석%영양소%림상약사
Total parenteral nutrition%Usage analysis%Nutrients%Clinical pharmacist
目的：：调查某院普外科住院患者全肠外营养( TPN)应用情况，为临床合理用药提供参考。方法：对某院2012年8月~2013年7月普外科住院患者的TPN处方情况进行回顾性统计分析。结果：116例患者接受TPN治疗共1013例次，以胃肠恶性肿瘤患者为主，占48.3%；平均用药天数为(8.7±3.2) d；总能量在900~1500 kcal之间；糖脂比值<1的处方878张(86.7%)；热氮比值为100~150的处方689张(68.0%)；一价阳离子浓度<150 mmol·L-1的处方有1008张(99.5%)、二价阳离子浓度<5 mmol·L-1的处方879张(86.8%)；使用谷氨酰胺的处方共765张(75.5%)，糖和胰岛素的比值(g：u)<3的处方共42张(4.1%)。结论：该院普外科住院患者TPN 使用存在的主要问题是大多数处方糖脂比偏低，少数处方存在热氮比不合理，阳离子浓度超量、胰岛素用量过高的等现象。临床医师应加强肠外营养知识的学习，临床药师应积极对肠外营养处方进行合理性干预，促进临床规范合理地进行肠外营养治疗，提高治疗效果。
目的：：調查某院普外科住院患者全腸外營養( TPN)應用情況，為臨床閤理用藥提供參攷。方法：對某院2012年8月~2013年7月普外科住院患者的TPN處方情況進行迴顧性統計分析。結果：116例患者接受TPN治療共1013例次，以胃腸噁性腫瘤患者為主，佔48.3%；平均用藥天數為(8.7±3.2) d；總能量在900~1500 kcal之間；糖脂比值<1的處方878張(86.7%)；熱氮比值為100~150的處方689張(68.0%)；一價暘離子濃度<150 mmol·L-1的處方有1008張(99.5%)、二價暘離子濃度<5 mmol·L-1的處方879張(86.8%)；使用穀氨酰胺的處方共765張(75.5%)，糖和胰島素的比值(g：u)<3的處方共42張(4.1%)。結論：該院普外科住院患者TPN 使用存在的主要問題是大多數處方糖脂比偏低，少數處方存在熱氮比不閤理，暘離子濃度超量、胰島素用量過高的等現象。臨床醫師應加彊腸外營養知識的學習，臨床藥師應積極對腸外營養處方進行閤理性榦預，促進臨床規範閤理地進行腸外營養治療，提高治療效果。
목적：：조사모원보외과주원환자전장외영양( TPN)응용정황，위림상합리용약제공삼고。방법：대모원2012년8월~2013년7월보외과주원환자적TPN처방정황진행회고성통계분석。결과：116례환자접수TPN치료공1013례차，이위장악성종류환자위주，점48.3%；평균용약천수위(8.7±3.2) d；총능량재900~1500 kcal지간；당지비치<1적처방878장(86.7%)；열담비치위100~150적처방689장(68.0%)；일개양리자농도<150 mmol·L-1적처방유1008장(99.5%)、이개양리자농도<5 mmol·L-1적처방879장(86.8%)；사용곡안선알적처방공765장(75.5%)，당화이도소적비치(g：u)<3적처방공42장(4.1%)。결론：해원보외과주원환자TPN 사용존재적주요문제시대다수처방당지비편저，소수처방존재열담비불합리，양리자농도초량、이도소용량과고적등현상。림상의사응가강장외영양지식적학습，림상약사응적겁대장외영양처방진행합이성간예，촉진림상규범합리지진행장외영양치료，제고치료효과。
Objective:To investigate the utilization of total parenteral nutrition ( TPN) in a hospital to provide reference for the clinical rational drug use. Methods:The utilization and trend of TPN in the surgical inpatients during August 2012 to July 2013 in the hospital were analyzed statistically. Results:Totally 116 patients received TPN with 1 013 times, and the patients with gastrointestinal malignant tumor accounted for 48. 3%. The average use day was (8. 7 ± 3. 2) d and the total energy was within the range of 900-1 500 kcal. The number of prescription with glycolipid ratio below 1 was 878 (86. 7%), that with hot nitrogen ratio of 100-150 was 689 (68. 0%), that with monovalent cation concentration below 150 mmol·L-1 was 1 008 (99. 5%), that with divalent cation concentra-tion below 5 mmol·L-1 was 879 (86. 8%), that with glutamine was 765 (75. 5%) and that with sugar and insulin ratio (g:u) be-low 3 was 42 (4. 1%). Conclusion:The maln problem in the TPN application in the hospital is that glycolipid ratio in the majority of prescriptions is low, and irrational hot nitrogen ratio, excessive cation concentration and insulin dosage appeared in the minority of pre-scriptions. Clinicians should strengthen the learning of parenteral nutrition knowledge and clinical pharmacists should actively perform reasonable intervention in the TPN prescriptions to promote the reasonable TNP therapy and improve the therapeutic effect.
