人血白蛋白注射液临床应用现状及合理使用策略研究

Study on Clinical Application and Rational Application Strategy of Human Serum Albumin Injection

目的:评价首都医科大学附属北京同仁医院人血白蛋白的临床应用现状,探讨该药的合理使用策略,促进药物的合理应用。方法:回顾性调查我院临床科室2016年1-6月人血白蛋白的应用情况。结果:我院2016年1-6月有31个临床科室839人使用人血白蛋白,其中普外科用药人数居首,占总人数的20.26%,其次是心内科、胸外科、干保科、儿科病房,主要用于低蛋白血症的防治(59.50%)、心肺分流术、烧伤、血液透析的辅助治疗(9.00%)、肝硬化及肾病引起的水肿和腹水(4.50%)等;用药前血清白蛋白浓度在30 g·L^(-1)以下的病例占69.00%,35 g·L^(-1)以上的占16.00%,且有5.00%诊断为低蛋白血症的病例在用药前并未检查血清白蛋白水平。人血白蛋白用药疗程1~30天,平均疗程为(3.73±1.97)天;个人用药总量以10~30 g居多,其患者例数占总病例数的30.00%,其次是40~60g,占24.00%。结论:我院人血白蛋白使用的问题主要集中在用药指证不明确、用药选择不合理、用药疗程偏长、与其他静脉药物联合使用等方面,提示我院对人血白蛋白的应用还存在一些误区,需加强对人血白蛋白的合理规范使用。

Objective： To evaluate the clinical application of human serum albumin in Beijing Tongren HospitalAffliated to Capital Medical University hospital and to explore the rational use of the drug in order to promote the rational application of the drug. Methods： The clinical application of human serum albumin of the clinical departments in our hospital from January, 2016 to June, 2016 was retrospectively investigated. Results： From January, 2016 to June, 2016, 839 patients from 31 clinical departments administrated human serum albumin, among which the number of the department of general surgical was the highest, accounting for 20.26% of the total number, followed by department of cardiology, department of thoracic surgery, department of cadre health, and department of pediatrics. Human serum albumin was mainly used for the prevention and treatment of hypoproteinemia（59.50%）, cardiopulmonary bypass, burn, hemodialysis adjuvant therapy（9.00%）, and edema and ascites caused by cirrhosis and kidney diseases（4.50%）, etc. Patients with pre-treatment serum albumin concentration lower than 30 g·L^-1 accounted for 69.00%, and with pre-treatment serum albumin concentration more than 35 g.L^-1 accounted for 16.00%. 5.00% of the patients diagnosed with hypoproteinemia were not checked before treatment. The treatment course was 1 to 30 days and the average treatment course was（3.73±1.97） days.The majority of the individual total amount of drug use was 10～30 g, accounting for 30.00% of the total number of patients, followed by 40～60 g, accounting for 24.00%. Conclusion： The problems of the use of human serum albumin in our hospital mainly focused on medication without clear indications, unreasonable selection of drugs, too long treatment course, combination with other intravenous drugs and so on, suggesting that there were still some misunderstandings about the application of human serum albumin in our hospital and the rational use of human serum albumin should be strengthened.