525例围手术期患者全胃肠外营养液处方分析.docxVIP

第 第 PAGE 1 页 共 NUMPAGES 1 页 525例围手术期患者全胃肠外营养液处方分析 摘 要 目的：分析围手术期患者全胃肠外营养液(TPN)处方医嘱，为临床合理使用TPN提供参考。方法：对我院普通外科2010年1-9月使用TPN的围手术期患者病历医嘱进行统计、分析。结果：有525例围手术期患者使用TPN，共3 345份，主要在糖脂能量比、非蛋白热氮比、处方组分不全及处方配伍等方面存在不足。结论：普通外科围手术期患者TPN处方还存在不足，需外科医师提高处方水平、药师强化审方意识，并应与临床医师加强沟通，进一步提高合理应用TPN的水平。  关键词全胃肠外营养液 围手术期 处方分析 合理用药  中图分类号：R977.6 文献标识码：A 文章编号：1006-1533(2011)09-0434-04  Analysis of total parenteral nutrition prescriptions during perioperative period in 525 patients  YUAN Ru-cai，CHEN Si-yi  （Dept. of Pharmacy，The Affiliated Hospital of Xuzhou Medical College，Xuzhou，221002）  ABSTRACTObjective: To investigate the prescriptions of total parenteral nutrition (TPN) during perioperative periodso as to provide references for its clinical rational use. Method: Cases using TPN during perioperative period in surgical department of our hospital from January to September 2010 were statistically analyzed. Results: A total of 525 patients received a total of 3 345 TPN and the main problems were involved in ratio of energy glucose to lipid，ratio of nonprotein energy to nitrogen， incompletion in basic composition and prescription compatibility. Conclution: There were some flaws in prescriptions ofTPN during perioperative period in surgical departmentandthe surgeon should strengthen learning. Meanwhile the pharmacists should strengthen review of prescription and often communicate with clinical physicians. The level of rational use of TPN remains to be further improved.  KEY WORDStotal parenteral nutrition；perioperative period；prescription analysis；rational use of drugs  全胃肠外营养液（total parenteral nutrition,TPN）是将机体所需的营养素按一定的比例和速度以静脉滴注方式直接输入体内的注射剂，可使各营养成分均衡地输入体内，提高了葡萄糖、氨基酸、脂肪乳三大营养素的利用率，减少了高渗葡萄糖和脂肪乳剂单独输注时可能发生的不良反应和并发症，临床使用越来越广泛。TPN对其适应证患者有显著效果, 可降低死亡率,提高治愈率, 加快康复, 缩短住院时间[1]。但TPN处方组成如存在缺陷会降低疗效，并可能增加不良反应。本文对我院普通外科围手术期患者TPN的处方医嘱进行统计、分析，以期为临床合理使用TPN提供帮助。  1资料与方法  检索我院普通外科2010年1-9月使用TPN的围手术期患者的病历号，据此查阅病历，记录每份病历的患者姓名、性别、年龄、所患疾病及TPN处方（包括药物名称、剂量及使用天数），进行统计分析。