某三级甲等医院营养素类药物使用情况调查分析

发布时间：2018-03-26 14:00

本文选题：营养素类药物　切入点：肠内营养　出处：《第四军医大学》2014年硕士论文

【摘要】：营养素类药物是指既是营养素又是在临床上使用于治疗和辅助治疗的药物。营养素（nutrient）是指食物中能给人体提供能量、构成机体和组织修复以及具有生理调节功能的化学成分。人体所必需的营养素共有6类，包括蛋白质、脂肪、碳水化物、维生素、无机盐（矿物质）和水。在人们的日常生活中，每天都必须有营养素的摄入，以维持正常的人体功能。在临床治疗中，营养素也可以作为药物使用，这就是营养素类药物。根据使用目的和使用方式的不同，，可以将营养素类药物分为肠内营养制剂、肠外营养制剂（静脉营养制剂）和其他营养素类药物。肠内营养制剂主要使用于通过胃肠道消化吸收食物的缓和；肠外营养制剂主要用于不能通过肠道摄取、消化和吸收食物患者的营养支持；其它营养素类药物指肠内营养制剂和肠外营养制剂之外的营养素类药物，其它营养素药物有维生素、矿物质和氨基酸等。由于营养素类药物使用面广、毒副作用小加上人们更关注营养保健等原因，近年来许多医院营养素类药物使用量迅速增加、价格上升、甚至出现了滥用和出现了不良反应。为了了解营养素类药物的使用现状，防止营养素类药物滥用，本文调查了某三级甲等医院营养素类药物的使用情况，并对这些药物的使用效益进行了分析，以便为医生、患者和医院管理者在选择营养素类药物时提供参考，为我国基本药物目录修改提供依据。目的：通过对某三级甲等医院2012年全年处方进行分析，调查营养素类药物使用情况。方法：通过回顾性方法对某三级甲等医院2012年全年处方进行调查分析，用Microsoft Excel2007和SPSS16.0分析了营养素类药物在该院药品费用中的比例；各类营养素类药物的使用量、使用金额和DDDs排序；医院不同科室使用营养素类药物的情况；营养素类药物导致的不良反应情况等。结果： 1、营养素类药物在医院使用药物中占的比例为20.04%，排名第1； 2、肠外营养素类药物的使用量排名第1； 3、肠内营养乳剂（TP）使用量最大； 4、肠外营养素类药物葡萄糖注射液使用量排名第1； 5、其他营养素类药物使用量最大的是叶酸片； 6、脑外科使用营养素类药物比较多； 7、营养素类药物应用年龄区间大，男女比例约为1:1； 8、使用营养素类药物的患者住院时间和费用小于不使用营养素类药物的； 9、患者使用营养素类药物出现不良反应。结论： 1、营养素类药物已经在临床中得到广泛使用； 2、肠外营养素类药物使用率高； 3、肠内营养素类药物中肠内营养乳剂（TP）使用量最大，金额排名第1，且DDDs排名第1，表明此药使用频率高； 4、肠外营养素类药物中葡萄糖注射液（20ml）使用量排名第1，临床广泛应用，复合磷酸氢钾注射液（2ml）DDDs排名第1，表明此药使用频率高，18种氨基酸注射液（5%）金额排名第1，但其DDDs排名第四，说明使用率比较低，减轻了患者的经济负担； 5、其他营养素类药物中的叶酸使用率大； 6、由于患者的特殊性使得脑外科使用营养素类药物比较多； 7、营养素类药物在使用的过程中不区分性别和年龄，只根据病情、身体状况等； 8、使用了营养素类药物比不使用此类药物的患者住院时间缩短，恢复更快，且医疗费用也明显下降； 9、尽量避免患者出现不良反应。
[Abstract]:Nutrients refers to a medicine which is both nutrients and is clinically used in the treatment and adjuvant treatment . The nutrient refers to the chemical components which can provide energy to the human body in the food , form the body and tissue repair and have physiological regulating function . In the daily life of people , nutrients can be divided into enteral nutrition preparation , parenteral nutrition preparation ( intravenous nutrition preparation ) and other nutrients .
The parenteral nutrition preparation is mainly used for the nutritional support of patients who cannot ingest , digest and absorb food through the intestinal tract ;
Other nutrients such as enteral nutrition preparation and parenteral nutrition preparation have vitamins , minerals and amino acids , etc . , because the use of nutrients is wide , the toxic and side effects are small , and people pay more attention to nutrition and health care .

In order to understand the status quo of the use of nutrients and to prevent the abuse of nutrients , this article investigated the use of the nutrient drugs in a class III hospital , and analyzed the use benefit of these drugs , so as to provide references for doctors , patients and hospital administrators to provide references for the selection of nutrients and provide the basis for the revision of basic drug catalogue in our country .

Purpose :

To investigate the use of nutrients by analyzing the prescription of a Class III hospital in 2012 .

Method :

In this paper , a retrospective method was used to investigate the annual prescription of a class III hospital in 2012 , and the proportion of nutrient drugs in the drug cost of the hospital was analyzed by Microsoft Excel 2007 and SPSS 16.0 .
the use amount , the use amount and the DDDs of various kinds of nutrient drugs are sorted ;
Use of nutrient drugs in different departments of the hospital ;
Adverse reactions caused by nutrient drugs , etc .

Results :

1 . The proportion of nutrients in the use of drugs in hospitals was 20.04 % , ranking No . 1 ;

2 . The use amount of parenteral nutrition drugs is ranked as the first ;

3 . The use of enteral nutrition emulsion ( TP ) was the largest .

4 . The dosage of parenteral nutrient glucose injection is ranked as the first ;

5 . The most use of other nutrients is the leaf acid tablet .

6 . There are many kinds of nutrients in brain surgery .

7 . The age interval of the application of nutrients is large , and the proportion of male and female is about 1 : 1 ;

8 . The time and cost of hospitalization for patients with nutrients are less than those without the use of nutrients ;

9 . Adverse reactions occurred in patients using nutrients .

Conclusion :

1 . Nutrients have been widely used in clinic .

2 . The utilization rate of parenteral nutrition drugs is high ;

3 . The use of enteral nutrition emulsion ( TP ) in enteral nutrition drugs is the largest , the amount is first , and DDDs is ranked first , which shows that the use frequency of this medicine is high ;

4 . The dosage of glucose injection ( 20 ml ) in parenteral nutrition drugs was ranked as the first , clinical application , compound potassium hydrogen phosphate injection ( 2ml ) DDDs was ranked as the first , indicating that the drug use frequency was high , 18 kinds of amino acid injection ( 5 % ) were ranked first , but the DDDs ranked fourth , indicating that the utilization rate was relatively low , and the economic burden of the patient was reduced ;

5 , the use rate of folic acid in other nutrients medicaments is large ;

6 . Because of the particularity of the patients , the use of nutrients in the brain surgery is much more .

7 . The nutrient drug does not distinguish between sex and age during use , only according to the condition , physical condition , etc . ;

8 . The use of nutrient drugs is shorter than that of patients who do not use such drugs , the recovery is faster , and the medical cost is also obviously decreased ;

9 . Try to avoid the patient ' s adverse reaction .

【学位授予单位】：第四军医大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R95

【参考文献】