2012~2014年我院急性胰腺炎患者营养药物使用情况调查

Investigation on the Utilization of Nutrient Drug among Acutepancreatitis Inpatients in our Hospital from 2012 to 2014

目的：评价我院急性胰腺炎患者临床营养药物的使用情况。方法：从我院医院信息系统（HIS）中提取2012~2014年急性胰腺炎患者基本情况和营养药物的应用信息,采用限定日剂量（DDD）方法,对用药频度（DDDs）、限定日费用（DDC）等进行分析。结果：急性胰腺炎住院患者例数逐年增加,平均住院时间、禁食时间和营养药物用药金额呈逐年下降趋势,但肠内营养使用构成比从2012年的23.8%增至2014年的25.6%,其中短肽型肠内营养混悬液（SP）的使用远高于其他肠内营养药物。3年来,氨基酸类药物使用金额及构成比呈下降趋势,其中复方氨基酸（18AA）的使用金额和DDDs排名稳居第一。脂肪乳剂（尤其是长链脂肪乳）的使用呈逐年上升趋势。全合一TPN制剂脂肪乳氨基酸葡萄糖注射液的使用有上升趋势,免疫营养药物谷氨酰胺丙酰胺注射液的使用金额始终排名在前两名,维生素类药物使用金额构成比相对较低,有下降趋势。结论：我院急性胰腺炎患者营养药物使用有下降趋势,目前仍以肠外营养制剂为主,但肠内营养药物在营养药物构成比逐年上升,反映了临床医师不断增强了对肠内营养药物的认知和重视,而各类肠外营养制剂的合理使用有待进一步加强。

Objective： To investigate the utilization of nutrition drugs among acutepancreatitis inpatients in 3years. Methods： The acutepancreatitis inpatients basic situation,and the utilization of nutrient drug during 2012-2014 was analyzed statistically through hospital information system,DDDs and DDC by the defined daily dose method. Results： From20012 to 2014,the acutepancreatitis inpatients increased year on year,while the average length of hospital stay and fasting time declined. The nutrition drug consumption sum declined,but the constituent ratio of EN rised year by year,from23. 8% in 2012 to 25. 6% in 2014,especially the use of enteral nutritional suspension. The consumption sum and constituent of amino acids ratio declined,but the DDDs ranking of 18 AA rised with the consumption sum and DDDs ranked first,then 20 AA was introduced in 2013,but not high DDDs. The use of fat emulsion amino acids（ 17） and glucose（ 11%） and fat emulsion were upwarded year on year especially the LCT. And the consumption sum of immune nutrition alanyl glutamine always ranked the second. While the consumption sum of vitamins was low with a downward trend. Conclusion： The utilization of nutrient drug among acutepancreatitis inpatients in our hospital was declined year on year. The constituent ratio of EN was rised although the PN given priority with average fasting time shortened. It showed the nutrition concept changing with the enhanced cognition of EN. Clinicians should further focus on the rational use of nutritional support in acutepancreatitis.