某三甲医院普外科2408例肠外营养处方分析

Analysis of 2 408 Parenteral Nutrition Prescriptions in the Department of Gastrointestinal Surgery in a Tertiary Hospital

目的:通过对某院普外科肠外营养(PN)处方合理性进行调查分析,为药师处方审核及临床合理用药提供参考。方法:对某三甲医院普外科2018年1~12月住院患者的PN处方情况进行回顾性统计分析,依据相关指南对全营养混合液处方进行合理性评价。结果:本次调查的2 408例PN的处方中96.4%的患者具有PN指征;但仍存在微营养素缺失(14.7%)、氨基酸品种选用不当(3.4%)、热氮比不合理(20.3%)、糖脂比不合理(17.9%)、阳离子浓度不合理(2.3%)、胰岛素用量过大(2.8%)等问题。结论:该院普外科PN处方主要存在热氮比、糖脂比不合理和微营养素缺失等问题,临床药师应积极对PN处方进行审核与干预,确保临床安全合理用药。

Objective:To investigate and analyze the rationality of parenteral nutrition(PN)prescription in general surgery department of a hospital,and provide reference for the standard treatment of clinical nutrition support.Methods:A retrospective statistical analysis was conducted on the PN prescriptions of hospitalized patients from January 2018 to December 2018 in the general surgery department of a tertiary hospital,and the rationality of the prescription of total nutrition mixture was evaluated according to relevant guidelines.Results:The PN prescriptions were basically reasonable in our hospital.However,there were still some problems such as deficiency of vitamin nutrients(14.7%),improper selection of amino acid varieties(3.4%),unreasonable non protein calorie and nitrogen ratio(20.3%),unreasonable ratio of glucose to lipid(17.9%),unreasonable cation concentration(2.3%)and excessive insulin dosage(2.8%).Conclusion:The main problems of parenteral nutrition prescription in general surgery department are unreasonable the ratio of non-protein calorie to nitrogen,unreasonable the ratio of glucose to lipid and micronutrient deficiency.Clinical pharmacists should actively review and intervene the prescription of parenteral nutrition to ensure the safe and rational use of drugs.