萧佐圣

[摘要] 目的 探討静脉用药调配中心肠外营养液配置不合理处方用药情况。 方法 从2020年1—12月我院静脉用药调配中心配置的肠外营养液中随机抽取500袋为研究对象。全部样本肠外营养液处方在调配之前均由静脉用药调配中心的药师预先进行审核，筛查不合理处方，记录不合理问题，并针对不合理问题及时与临床医生沟通，确认或修改医嘱。回顾性分析样本肠外营养液的处方审核结果，统计处方不合理率，汇总不合理表现。 结果 经审核，筛查出不合理肠外营养液处方13张，不合理率为2.60%。13张不合理处方共涉及4个不合理医嘱项目，包括配伍不当6条（42.86%）、组分超量5条（35.71%）、处方输入错误2条（14.29%）、组分重复1条（7.14%）。 结论 我院静脉用药调配中心肠外营养液配置基本合理，但仍有不足，与临床医生相关理论知识掌握不足、经验不够丰富等因素有关，建议定期开展肠外营养液配置相关培训与考核工作、加强营养液配置管理、强化营养液配置前处方审核工作等，以提高处方合理性，更好地保障患者治疗安全。

[关键词] 静脉用药调配中心;肠外营养液;处方;不合理用药

[中图分类号] R459.3          [文献标识码] B          [文章编号] 1673-9701（2021）32-0147-03

[Abstract] Objective To investigate the irrational prescription drug use in the nutrition solutions preparation of the intravenous drug dispensing center. Methods From January to December 2020， 500 bags of parenteral nutrition solutions prepared by our intravenous drug dispensing center were randomly selected as the study subjects. Before dispensing， the prescription of parenteral nutrition solutions for all samples was reviewed in advance by the pharmacist of the Intravenous Drug Dispensing Center， irrational prescriptions were screened， irrational problems were recorded， and timely communication was made with the clinician to confirm or modify the doctor's advice for irrational problems. The prescription review results of sample parenteral nutrition solutions were retrospectively analyzed. The unreasonable prescription rate was counted， and the unreasonable performance was summarized. Results After review， 13 irrational parenteral nutrition prescriptions were screened， with an irrational rate of 2.60%. A total of 4 irrational medical order items were involved in the 13 irrational prescriptions， including 6（42.86%） with improper compatibility， 5 （35.71%） with excessive components， 2 （14.29%） with prescription input errors， and 1 （7.14%） with repeated components. Conclusion The parenteral nutrition solution preparation in the intravenous drug dispensing center in our hospital is basically reasonable but still insufficient， related to the lack of mastery of relevant theoretical knowledge of clinicians， lack of experience and other factors. It is recommended to regularly carry out the training and assessment related to the preparation of parenteral nutrition solutions， strengthen the management of nutrient solution configuration， and strengthen the review of prescription before the preparation of the nutrition solutions， so as to improve the rationality of prescription and better ensure the treatment safety of patients.

[Key words] Intravenous drug dispensing center; Parenteral nutrition solutions; Prescription; Unreasonable prescription drug use

肠外营养是临床常用营养支持方式，适用于各种因素所致不能经口进食或营养摄入不全的患者。依据营养需求程度的不同，肠外营养分为部分肠外营养与完全肠外营养两种[1]，其中完全肠外营养又称静脉高营养，营养液由氨基酸、脂肪乳、葡萄糖、电解质、维生……