1843张新生儿全肠外营养液处方分析

Rationality Evaluation on 1843 Neonatal Total Parenteral Nutrition Solution Prescriptions

目的调查与分析新生儿科全肠外营养(TPN)处方情况,为进一步规范TPN,保障新生儿肠外营养支持的安全性、有效性提供参考。方法统计青岛大学附属医院静脉用药调配中心(PIVAS)2017年1—6月调配的新生儿TPN处方(共计1843张),从病种、处方配比等方面进行统计分析,探讨新生儿TPN合理性及稳定性的影响因素。结果1843张处方中,病种符合新生儿TPN适应证,支持时间5~40 d(平均11 d)。葡萄糖浓度较合理,氨基酸浓度不合理处方428张(23.22%),阳离子浓度不合理处方184张(9.98%),热氮比不合理处方276张(14.98%),糖脂比不合理处方316张(17.15%)。结论 TPN处方存在组分不当的情况,药师应严格审核处方,以保障临床新生儿TPN的安全性和有效性。

Objective To investigate and analyze total parenteral nutrition(TPN)prescriptions in the neonatal units,and to provide further reference for standardized use and ensure the safety and the effectiveness of the neonatal parenteral nutrition support.Methods A total of 1843 newborn parenteral nutrition prescriptions in the pharmacy intravenous admixture services(PIVAS)of the affiliated hospital of Qingdao university were selected from January 2017 to June 2017.Disease category and prescription were statistically analyzed to explore the influence factors on the rationality and stability of TPN.Results The diseases in 1843 prescriptions conformed to indications for neonatal parenteral nutrition.The time of TPN support was 5-40 days(an average of 15 days).Glucose concentration was reasonably controlled.Totally,428 cases(23.22%)had irrational proportion of amino acid,184 cases(9.98%)had irrational amino acid concentration,276 cases(14.98%)unreasonable thermal nitrogen ratio,and 316 cases(17.15%)unreasonable glycolipid ratio.Conclusion There are some problems in component ratio of neonatal TPN prescriptions.Pharmacists should strictly check the prescription to ensure the safety and effectiveness of clinical neonatal TPN.