应用国际指南评价某院外科住院患者人血白蛋白临床使用情况

Evaluation of Clinical Utilization of Human Serum Albumin in Surgical Inpatients in A Hospital by International Guidance

目的:为外科住院患者人血白蛋白临床合理使用提供参考。方法:分析某院外科2014年1-3月住院患者人血白蛋白的使用情况,并以美国大学医院联合会(UHC)制订的《人血白蛋白、非蛋白胶体及晶体溶液使用指南》(2010版)和欧洲《免疫球蛋白及白蛋白使用推荐》为标准进行评价。结果:556例患者共提交了895份人血白蛋白使用申请,主要集中在胃肠外科(29.7%)、肝胆外科(25.9%)和胸心外科(13.1%)。主要的用药理由为纠正低白蛋白血症(62.9%),其次是大手术期间的白蛋白补充(7.9%)和减轻肝硬化患者的腹水(4.4%);仅95份(10.6%)人血白蛋白申请理由符合指南适应证。最主要的不适宜用药理由为纠正低白蛋白血症。结论:该院外科住院患者人血白蛋白用量大,且其适应证与指南相符率低,需加强人血白蛋白的合理、规范使用。

OBJECTIVE： To provide reference for rational use of human serum albumin for surgical inpatients. METHODS： The utilization of human serum albumin for surgical inpatients in a hospital during Jan.-Mar. 2014 was analyzed and evaluated by UHC Guidelines for the Use of Album, Nonprotein Colloid, and Crystalloid Solutions （2010 edition） and European Immune Globulin and Albumin Use Recommendation. RESULTS： Among the 556 patients, totally 895 human serum albumin application were conducted, mainly involving development of gastrointestinal surgery （29.7%）, hepatobiliary surgery （25.9%） and cardiothoracic surgery （13.1%）. The main reasons were correcting hypoalbuminemia （62.9%）, followed by albumin supplemented during major surgery （7.9%） and alleviating ascites in patients with cirrhosis （4.4%）; only 95 applications （10.6%） were considered appropriate. The most prevalent inappropriate reason was for correcting hypoalbuminemia. CONCLUSIONS： Human serum albumin in the surgical inpatients in the hospital shows a large amount, and low consistent rate between indications and guidelines. The rational standardized utilization of human serum albumin should be strengthened.