住院患者肠内营养药品临床使用情况的调查研究

Survey on Clinical Use of Enteral Nutrition Supplements Among Inpatients

目的:回顾性调查肠内营养药品的临床使用情况,初步分析不合理因素,为肠内营养药品的临床合理用药提供参考。方法:收集我院2017年肠内营养药品的用药医嘱,统计肠内营养药品的使用情况,包括用药人次、能量用量和处方日能量(prescribed daily energy,PDE)。统计各种肠内营养药品的用药途径。结果:共纳入使用肠内营养药品的用药医嘱35009人天,占比前3位的药品分别是TPF-D(32. 76%)、TPF-T(22. 65%)、TP(14. 33%)。在住院患者中,除TP粉剂外,其他剂型的肠内营养药品主要经管饲给予。TP的PDE为2038 kcal/人天;TPF的PDE为1 048 kcal/人天;SP的PDE为732 kcal/人天;TPF-FOS的PDE为875kcal/人天;TPF-D的PDE为905 kcal/人天;TPF-T的PDE为700 kcal/人天。用药人次居前3位的是急危重症科(11 144人天)、老年科(7 291人天)和综合科(4 037人天);PDE居前3位的科室是血液内科(1 866 kcal/人天)、康复科(1 669 kcal/人天)和消化内科(1 522 kcal/人天)。其中,急危重症科TP的PDE(6 374 kcal/人天)存在显著异常。结论:各种肠内营养药品在临床各科室广泛使用,尤其是特殊应用型肠内营养。急危重症科肠内营养的使用存在显著异常,建议进一步分析不合理因素,健全管理机制。

Objective：To retrospectively investigate the clinical use of enteral nutrition supplements and analyze the irrational factors, and to provide references for the optimal management of the clinical use of enteral nutrition supplements. Methods ： All medical orders of enteral nutrition supplements were included in our hospital in 2017. We summarized situation of enteral nutrition use in the hospital and all departments, analyzed the number of patient-days, energy consumption and prescription daily energy （PDE）. Summarized the route of administration of various enteral nutrition supplements. Results ： A total of 35 009 patient-days of the use of enteral nutrition supplements were included, the top 3 supplements were TPF-D （32. 76% ）, TPF-T （22. 65% ）, and TP （ 14. 33% ）. Among inpatients, in addition to TP powder, other enteral nutrition supplements are mainly administered by tube feeding. The top 3 departments of enteral nutrition supplements use are emergency and intensive care unit （11 144 patient-days）, geriatrics ward （7 291 patient-days）, and general ward （4 037 patient-days）. The top 3 departments of PDE are hematology department （1 866 kcal/patient-days）, rehabilitation department （1 669 kcal/patient-days） and Digestive Department （1 522 kcal/patient-days）. Moreover, there was a significant abnormality in PDE （6 374 kcal/patient-days） of TP use in the emergency and intensive care unit. Conclusion： Enteral nutrition supplements are widely used in all departments, especially the special application types. There is a significant abnormality in the use of enteral nutrition in the emergency and intensive care unit. Further studies should be conducted to analyze the irrational factors and to improve the management.