广东省部分基层卫生院静脉输液使用情况调查分析

Investigation and Analysis of Intravenous Transfusion in Some Basic-level Hospitals in Guangdong Province

目的了解广东省基层卫生院静脉输液使用情况,为规范化管理静脉输液提供依据。方法从广东省韶关市、清远市、潮州市、梅州市选取9家卫生院,随机抽取各医院2015年7月24日100份门诊处方及10份病历,统计分析门诊、住院输液情况,并对输液处方和医嘱的合理性进行评估。结果共抽取门诊处方743张,住院病历60份。门诊、住院患者平均输液率分别为40.35%、98.89%,日人均输液量分别为1袋、4袋;静脉滴注抗菌药物使用率分别为32.07%、81.67%;输液处方和病历不合理率分别为84.27%、87.18%,其主要问题为适应证不适宜,门诊及住院分别为57.38%、73.62%;其次为用法用量不适宜,门诊及住院分别为49.29%、37.47%。结论广东基层卫生院存在滥用静脉输液问题,尤其是静脉用抗菌药物,建议相关部门制定临床静脉输液规范,加强监督和管理,促进临床静脉输液的合理使用。

OBJECTIVE To investigate the situation of intravenous transfusion in basic-level hospitals in Guangdong province,and to provide information for standardized management of intravenous transfusion. METHODS A total of 100 outpatient prescriptions and 10 medical records during July 20th to 24th,2015 were selected randomly in 9 basic-level hospitals from Shaoguan,Qingyuan,Chaozhou,and Meizhou city. The rationality of the infusion orders was evaluated. RESULTS 743 outpatient prescriptions and 60 medical records were extracted,infusion rate of outpatient and inpatient was 40.35% and 98.89%,respectively. 1 and 4 bags of infusion fluid were consumed by outpatient and inpatient every day. 32. 07% of the outpatients and 81. 67% of the inpatients were prescribed intravenous antimicrobial drugs. The unreasonable rate of infusion prescription and medical record was 84. 27% and 87. 18%,respectively,and the most common problems were over-indication and inappropriate-usage. CONCLUSION Overprescribing and misprescribing of intravenous transfusion and antimicrobial agents in basic-level hospitals in Guangdong Province was common,thus it is suggested that the guidelines and standardizations of clinical transfusion should be established to promote the rational and standard use of transfusion.