我院急诊患者人血白蛋白使用分析

Analysis on the Clinical Application of Human Serum Albumin in Emergency Patients in Our Hospital

目的:了解急诊患者人血白蛋白的使用情况,为其合理使用提供参考。方法:选择2017年7～12月北京协和医院使用人血白蛋白的急诊患者为研究对象,根据处方及人血白蛋白使用申请,通过HIS系统调取患者性别、年龄、病历号、临床诊断、人血白蛋白指标、申请理由等信息,采用Excel进行记录、统计与分析。结果:用药前1 268例次(96. 06%)患者的血清白蛋白浓度≤30 g·L-1;申请原因以低蛋白血症为主的占66. 89%;将临床诊断与中国人血白蛋白使用说明书、北京市医保规定中推荐的适应证及美国大学医院联盟《人血白蛋白、非蛋白胶体及晶体溶液使用指南》(简称"美国UHC指南")进行比较,相符率分别为98. 71%、75. 83%及9. 39%。结论:我院急诊患者人血白蛋白的使用基本符合药品说明书及北京市医保机构的规定,但与美国UHC指南差异较大。

Objective:To analyze the clinical application of human serum albumin (HSA)in our hospital to provide reference for clinical treatment.Methods:The emergency patients using human serum albumin in Peking union medical college hospital during June and December in 2017were collected by hospital information system.The data in aspects of sex,age,medical record number,clinical diagnosis,human albumin index and reasons for application were recorded and statistically analyzed by Excel.Results:Totally 1268 records had a baseline serum albumin level less than 30g·L^-1(96.06%).Most of the patients used the drug for hypoproteinemia (66.89%).Based on human serum albumin dispensatory,medical insurance regulations in Beijing and Non-protein Colloid and Crystalloid Solution Guidelines of USA university hospital consortium,the guideline of HSA use and the rational use of HSA were evaluated, and the coincidence rate was 98.71%,75.83%and 9.39%,respectively.Conclusion:The use of human serum albumin in our hospital basically conforms to the dispensatory and the medical insurance organizations of Beijing.However,it is not in compliance with the regulations on the guidelines of the hospital associations of American universities.