肿瘤患者营养支持药物利用调查分析

Survey and analysis of nutrient support drug utilization in cancer patients

目的 了解我院肿瘤患者营养支持药物使用情况。方法 通过调查我院 1999年～ 2 0 0 2年药库明细帐和 2 0 0 2年 10 14份病历 ,用药物利用研究方法 ,分析我院营养支持药物的用药结构、用药合理性等。结果 4年间这类药物的使用品种、数量、金额上升了 5 8 82 %、71 6 6 %和 2 8 16 % ;在调查病历中 4 9 30 %的肿瘤患者使用了这类药物 ,肠外营养 (PN)和肠内营养 (EN)药物使用数量比为 14∶1;人次比为 13∶1;其中营养不良患者为 19 80 % ;在可判定DDD值的PN药物中 ,大部分DUI值大于 1,EN药物大部分DUI值小于 1。结论 营养支持药物的使用品种、数量、金额 4年间提升很快 ;PN药物的使用数量和人次远高于EN药物 ;对部分患者实施营养支持治疗的适应症掌握令人质疑 ;部分营养支持药物的使用剂量不尽合理。如何合理应用营养支持治疗需要进一步探讨。

Objective To find out nutrient support drug utilization in cancer patients in our hospital. Methods An analysis was made by means of drug utilization research into the structure and rationality of nutrient support drug utilization in our hospital through an investigation into the detailed records of the dispensary from 1999 to 2002 and into 1 014 medical records from 2002. Results The variety, quantity, and cost of nutrient support drug utilization in the four years rose respectively by 58.82%, 71.66% and 28.16%. 49.30% of the cancer patients whose medical records were surveyed used such drugs. The quantity and person time ratio of PN and EN drug utilization was respectively 14∶1 and 13∶1, with malnourished patients accounting for 19.80%. Of the PN drugs whose DDD value could be determined, most had a DUI value that was greater than 1 whereas most of the EN drugs had a DUI value which was smaller than 1. Conclusion The variety, quantity, and cost of nutrient support drug utilization in the four years rose rapidly. The quantity and person time of PN drug utilization were much higher than those of EN drug utilization. Doubts could be cast in the handling of indications for nutrient support drug utilization in some patients and the doses of some nutrient support drugs prescribed were not so rational. Further explorations need to be made into the rational application of nutrient support treatment.