2015-2016年我院人血白蛋白临床使用合理性评价

Evaluation of the rationality of clinical use of human serum albumin in our hospital from 2015 to 2016

目的通过分析医院2015-2016年度人血白蛋白临床使用的情况,评价其用药的合理性。方法抽取527例在2015-2016年度使用人血白蛋白的患者,收集相关临床信息资料并统计,结合现有的循证药学证据、根据北京市处方点评工作组制定的《血液制品处方点评指南》以及我国人血白蛋白使用说明书为标准,对人血白蛋白使用合理性进行评价。结果应用人血白蛋白的患者以70岁以上老年人为主共239例(45.35%);用药涉及医院27个科室,排名前三的科室分别为心胸外科(14.36%)、肝胆外科(13.00%)和消化内科(9.40%);患者用药总量在20~50 g184例(34.91%),用药量<20 g 152例(28.84%),用药在50~100 g有132例(25.05%);用药前有30.36%的患者未检测血清白蛋白水平;个人用药量、用药原因以低蛋白血症或防治低蛋白血症的有252例(47.82%);分别以北京市处方点评工作组制定的《血液制品处方点评指南》以及我国人血白蛋白使用说明书为标准评价医院人血白蛋白使用适应证,合理率为67.76%。结论人血白蛋白临床使用仍然存在多种不合理情况,加强人血白蛋白的监管对于提高我院人血白蛋白安全、合理、经济使用迫在眉睫。

Objective By analyzing the clinical use of human serum albumin in the hospital from 2015 to 2016 to evaluate the rationality of its use. Methods 527 cases of patients taking human serum albumin in 2015-2016 were selected and relevant clinical information was collected and statistically analyzed. Combined with the existing evidence-based pharmacogenetic evidence,the rationality of using human serum albumin was evaluated according to the＂Guidelines for the Evaluation of Prescriptions for Blood Products＂formulated by the Beijing Review Office Working Group and the manual of human serum albumin in China. Results There were 239 cases（ 45. 35%） of patients with over 70 years of age who were treated with human serum albumin. There were 27 departments in our hospital. The top three departments were cardiothoracic surgery（ 14. 36%）,hepatobiliary surgery（ 13. 00%） and gastroenterology（ 9. 40%）. There were 184 cases（ 34. 91%） in the range of 20 ~ 50 g,152 cases（ 28. 84%） in the dosage of less or equal to 20 g and 132 cases（ 25. 05%） of drug dosage was in the range of50 ~ 100 g; 30. 36% patients before treatment did not detect serum albumin levels; There were 252 cases（ 47. 82%） of the patients taking hypoglycemia or preventing hypoproteinemia due to the dosage of drugs. The prescription of blood products developed by Beijing Prescription Review Working Group and the manual of human albumin of human beings in our country were used as the standard to evaluate the indication of human albumin use in our hospital. The reasonable rate was found to be67. 76%. Conclusion There is still much irrationality in using human serum albumin clinical. It is highly imperative and imminent to strengthen the regulation of human serum albumin in our hospital to improve the safety of human albumin,reasonable,economical use.