人血白蛋白在住院患者中的临床使用情况调查

Investigation of the Clinical Use of Human Albumin in Hospitalized Patients

目的调查住院患者人血白蛋白使用情况,并结合指南及循证证据对其临床使用情况进行分析,为后续开展白蛋白使用合理性评价提供参考,以促进临床合理用药。方法随机抽取中国9个地区120家医院2016年1月—2020年12月住院患者使用人血白蛋白的数据,对人血白蛋白处方量、取药数量、消费金额、科室分布、适应证进行分析。结果共抽取处方756055张,人血白蛋白产品主要依赖进口。2016—2020年,人血白蛋白使用量呈稳态缓慢增加趋势。对9个地区平均每年每家医院处方量、取药数量及处方金额进行比较,排名前三位地区均为杭州、广州和成都,哈尔滨最低。人血白蛋白消耗巨大,平均每年每家医院消费金额207695~2213604元。9个地区处方量和处方金额排名前3位的科室主要集中在重症监护室(ICU)和外科系统;肿瘤处方占比最多,其次为心脏和肝脏疾病。结论人血白蛋白使用量巨大,部分适应证仍存在争议,需要进一步开展循证评价。有必要对人血白蛋白使用较多的科室和疾病领域开展专项点评,以降低不合理使用率,降低医疗成本,促进临床合理使用。

Objective The clinical use of human albumin in inpatients was investigated and analyzed in combination with guidelines and clinical evidence,in order to provide a reference for follow-up evaluation of the rational use of human albumin and promote further rational use.Methods Data on the use of human albumin in inpatients from 120 hospitals in 9 regions of China from January 2016 to December 2020 were randomly selected,and the prescription quantity,drug quantity,consumption,department distribution,and indications were analyzed.Results A total of 756055 prescriptions were selected in the study,and most human albumin products were imported.From 2016 to 2020,the use of human albumin showed a steady increasing trend.Compare to the average annual prescription quantity,drug quantity,and prescription amount of each hospital in 9 regions,the top three regions were Hangzhou,Guangzhou,and Chengdu,and Harbin was the lowest.The consumption of human albumin was huge,with an average annual consumption of 207695-2213604 yuan per hospital.The top departments in terms of prescription quantity and prescription amount in 9 regions were the ICU and surgical system.The tumor prescriptions accounted for the largest proportion,followed by heart and liver diseases.Conclusion Human albumin was widely used,and some indications were still controversial,which required further evidence-based evaluation.It was necessary to carry out special comments by pharmacists in departments and disease fields where human albumin was used more frequently,in order to reduce the unreasonable use rate,reduce medical costs,and promote rational clinical use.