目的：对医院肝胆外科肠外营养液（TPN）处方的合理性进行调查分析，为进一步规范TPN的使用提供参考。方法采用回顾性分析方法，依据《临床诊疗指南·肠外肠内营养学分册（2008版）》要求，对医院肝胆外科5个病区2014年1至2月的TPN处方共1532张进行合理性审查，审查项目包括营养素组成及每张处方的液体量、电解质浓度、糖脂比、热氮比、丙氨酰谷氨酰胺用量及影响稳定性的相关因素等。结果医院肝胆外科部分TPN处方糖脂比、热氮比、丙氨酰谷氨酰胺用量等存在不合理现象。药师通过审方，及时与临床医生、护士沟通，使不合理处方得以纠正。结论药师可通过审核处方对不合理处方及时干预，协助临床进一步提高TPN治疗的有效性、安全性、经济性。%Objective To investigate and analyze the rationality of total parenteral nutrition(TPN) prescriptions in the hepatobiliary surgery department so as to provide reference for further standardizing the rational use of TPN in clinic. Methods By adopting the ret-rospective analysis method,the rationality in 1 532 pieces of TPN prescriptions in the hepatobiliary surgery department of our hospital from January to February 2014 were performed the investigation on the items of the amount of liquid,electrolyte concentration,ratio of glucose to lipid,ratio of non-protein energy to nitrogen,amount of alanyl-glutamine and related factors influencing the TPN stability, according to the requirements of Chnical Diagnosts and Treatment Guideline· Parenteral and Enteral Nutrition Fascicule( 2008 edition). Results The unreasonable phenomena existed in the ratio of glucose to lipid,ratio of non-protein energy to nitrogen and amount of alanyl-glutamine among the partial TNP prescriptions. Pharmacists timely communicated with clinical doctors and nurses by checking the prescriptions and corrected the irrational prescriptions. Conclusion Pharmacists can conduct the timely intervention on the irrational prescriptions by checking the prescriptions and assist clinic to further increase the effectiveness,safety and economy of TPN therapy.
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