某院2014年-2015年人血白蛋白注射液临床应用分析

发布时间：2018-05-15 12:54

本文选题：人血白蛋白注射液 + 低蛋白血症　；参考：《郑州大学》2016年硕士论文

【摘要】：目的初步探讨人血白蛋白注射液在临床使用中的综合情况,点评病历,分析不合理用药原因,为临床用药以及病历点评提供参考,最终达到合理用药、减轻患者负担及优化白蛋白制剂资源使用的目的。方法提取某三级综合医院2014~2015年中所有使用人血白蛋白制剂患者的病历,共计5617份病历。从使用人血白蛋白的患者年龄、人血白蛋白年度使用量、科室使用分布、每位患者使用量、疾病种类分布等方面,探讨人血白蛋白注射液在该院使用的总体情况;抽取部分使用白蛋白的过往病历进行点评,从使用前血清白蛋白值、点评病历的疾病分类及不合理使用原因方面探讨人血白蛋白在临床使用中具体合理性。结果提取5617份病历中,292份用于小于1岁的婴儿患者,41-90岁患者使用人血白蛋白病历占82%左右,60岁以上老年患者占57%以上;小于1岁的婴儿患者,心脏手术和新生儿高胆红素血症为使用白蛋白制剂的主要指证;人血白蛋白使用涉及到的科室和疾病种类广泛,该院几乎所有科室均有使用人血白蛋白的情况;且该院患者使用人血白蛋白的剂量以10~40g为主,且2015年相比2014年,平均每名患者的使用剂量有逐渐增加的趋势;外科术后补充血容量及纠正低蛋白血症、肿瘤患者纠正低蛋白血症、脑血流灌注患者降低颅内压为使用人血白蛋白前三用药原因;共计点评233份病历,不合理病历118份,不合理率达50.64%,不合理用药原因涉及用药前未测定患者血清白蛋白值、使用指证不足、使用量偏大及存在用药禁忌症等各个方面。结论该院人血白蛋白使用广泛,涉及各个年龄的患者、各个住院病区、各种疾病种类;使用患者数量、平均每位患者使用量和药品数量也呈逐渐递增的趋势,存在乱用滥用的隐患;临床使用过程中,存在用药前未测定患者血清白蛋白值、使用指证不足、使用剂量偏大及存在用药禁忌症等各个方面的不合理用药现象。
[Abstract]:Objective to preliminarily discuss the comprehensive situation of Human Albumin Injection in clinical use, review the medical records, analyze the reasons for irrational drug use, provide reference for clinical medication and medical record review, and finally achieve the purpose of rational drug use, reduce the burden of patients and optimize the use of albumin preparation resources. Methods to extract a three grade comprehensive hospital for 2014~2015 years. A total of 5617 medical records were used in all the patients with Human Albumin preparation. From the age of the Human Albumin, the annual use of Human Albumin, the distribution of the Department, the use of each patient, the distribution of the disease type, and so on, the general situation of the use of Human Albumin Injection in the hospital was discussed; some white eggs were used to extract the white eggs. A review of the past medical records of white, the specific rationality of Human Albumin in clinical use was discussed from the pre use serum albumin value, the classification of the disease records and the reasons for irrational use. Results 292 of the 5617 medical records were used for infants less than 1 years old, and 41-90 year old patients used the Human Albumin medical record 82%, 60 More than 57% of the elderly patients over the age of age were more than 57%; in infants younger than 1 years of age, cardiac surgery and neonatal hyperbilirubinemia were the main indications for the use of albumin; Human Albumin used a wide range of departments and diseases, and almost all departments of the hospital had the use of Human Albumin; and the patients used white eggs in the hospital. The white dose was dominated by 10~40g, and in 2015 compared to 2014, the average dosage of each patient was gradually increasing; after surgery, the volume of blood was supplemented and the hypoproteinemia was corrected, the tumor patients corrected the hypoproteinemia, and the cerebral blood flow patients decreased the intracranial pressure for the first three causes of the use of Human Albumin; a total of 233 medical records were reviewed. The irrational medical record was 118, the irrational rate was 50.64%. The reason for irrational use of drugs involved the unmeasured serum albumin value of the patients before drug use, the lack of indications, the large amount of use and the contraindication of drug use. Conclusion the Human Albumin is widely used in all ages, inpatient areas and various kinds of diseases. With the number of patients, the average use of each patient and the number of drugs also increased gradually, and there was a hidden danger of misuse. In the process of clinical use, there was not the value of serum albumin in the patients before drug use, the lack of indications, the use of large doses and the existence of drug taboos and other irrational drug use.

【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R977

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