应用国际指南评价某院外科住院患者人血白蛋白临床使用情况

摘要

目的：为外科住院患者人血白蛋白临床合理使用提供参考。方法：分析某院外科2014年1－3月住院患者人血白蛋白的使用情况，并以美国大学医院联合会（UHC）制订的《人血白蛋白、非蛋白胶体及晶体溶液使用指南》（2010版）和欧洲《免疫球蛋白及白蛋白使用推荐》为标准进行评价。结果：556例患者共提交了895份人血白蛋白使用申请，主要集中在胃肠外科（29.7％）、肝胆外科（25.9％）和胸心外科（13.1％）。主要的用药理由为纠正低白蛋白血症（62.9％），其次是大手术期间的白蛋白补充（7.9％）和减轻肝硬化患者的腹水（4.4％）；仅95份（10.6％）人血白蛋白申请理由符合指南适应证。最主要的不适宜用药理由为纠正低白蛋白血症。结论：该院外科住院患者人血白蛋白用量大，且其适应证与指南相符率低，需加强人血白蛋白的合理、规范使用。%OBJECTIVE:To provide reference for rational use of human serum albumin for surgical inpatients. METHODS:The utilization of human serum albumin for surgical inpatients in a hospital during Jan.-Mar. 2014 was analyzed and evaluated by UHC Guidelines for the Use of Album,Nonprotein Colloid,and Crystalloid Solutions(2010 edition)and European Immune Globu-lin and Albumin Use Recommendation. RESULTS:Among the 556 patients,totally 895 human serum albumin application were con-ducted,mainly involving development of gastrointestinal surgery(29.7%),hepatobiliary surgery(25.9%)and cardiothoracic sur-gery(13.1%). The main reasons were correcting hypoalbuminemia(62.9%),followed by albumin supplemented during major sur-gery(7.9%)and alleviating ascites in patients with cirrhosis(4.4%);only 95 applications(10.6%)were considered appropriate. The most prevalent inappropriate reason was for correcting hypoalbuminemia. CONCLUSIONS:Human serum albumin in the surgi-cal inpatients in the hospital shows a large amount,and low consistent rate between indications and guidelines. The rational stan-dardized utilization of human serum albumin should be strengthened.