杨丝露 柳波 徐帆

中圖分类号 R95 文献标志码 A 文章编号 1001-0408（2021）17-2133-06

DOI 10.6039/j.issn.1001-0408.2021.17.15

摘 要 目的：为医疗机构开发与应用肠外营养处方决策支持系统以及提高临床肠外营养精准治疗水平提供理论依据。方法：基于肠外营养处方审核要点设计肠外营养处方决策支持系统，对系统各模块的功能要点及处方审核逻辑进行探讨，并应用该系统对100张临床肠外营养处方进行审核。结果：信息化肠外营养处方决策支持系统包含评价指标管理模块、药品管理模块、指标知识管理模块、指标计算与评价模块和反馈追踪模块。肠外营养处方审核的逻辑应以评价指标为基础，构建合理性知识库、安全性知识库和药品属性库，并基于上述知识库、患者情况及处方信息的调用与计算，最终形成对处方的安全性和合理性的评价结果集。基于该设计理念构建的肠外营养处方决策支持系统实现了全营养混合液处方中各项指标的自动化审核和警示，可快捷、高效地审核出肠外营养处方的安全性与合理性问题;经人工判断，该系统对100张处方的审核结果全部正确无误。结论：肠外营养处方审核的基础是评价指标的确定，技术难点在于考虑个体化和合理性的同时还要兼顾肠外营养液的安全稳定性。完善的信息系统的应用有助于促进临床肠外营养精准化合理用药和提高医务人员的工作效率。

关键词 肠外营养;处方审核;信息化;系统

Development and Application of Information-based Parenteral Nutrition Prescription Review System

YANG Silu1，LIU Bo1，XU Fan2（1. College of Pharmacy， Dali University， Yunnan Dali 671000， China; 2. Dept. of Pharmacy， No. 920 Hospital of Joint Logistic Support Force of PLA， Kunming 650032， China）

ABSTRACT   OBJECTIVE： To develop and apply a parenteral nutrition prescription decision support system for medical institutions and provide theoretical basis for improving clinical parenteral nutrition precision treatment. METHODS： Based on the review points of parenteral nutrition prescription， the parenteral nutrition prescription decision support system was designed; the function points and prescription review logic of each module of the system were discussed， and the system was also used to review 100 pieces of clinical parenteral nutrition prescriptions. RESULTS： Information-based parenteral nutrition prescription decision support system included evaluation index management module， drug management module， index knowledge management module， index calculation and evaluation module， feedback and tracking module. The logic of parenteral nutrition prescription review were based on the evaluation indexes， and rationality knowledge base， safety knowledge base and drug attribute base were constructed. Based on the above knowledge bases， patient information and prescription information call and calculation， the evaluation result set of safety and rationality of the prescription was finally formed. Based on this design concept， the parenteral nutrition prescription decision support system realized the automatic review and warning of various indicators in TNA prescription， and can quickly and efficiently review the safety and rationality of parenteral nutrition prescription. Through manual judgment， the audit results of 100 prescriptions by the system were all correct. CONCLUSIONS： The basis of parenteral nutrition prescription review is the formulation of evaluation indexes， and the technical difficulty lies in considering the individuality and rationality as well as the safety and stability of parenteral nutrition solution at the same time. The application of a well-structured information system will promote the precise and reasonable medication of parenteral nutrition and improve work efficiency of medical personnel.

KEYWORDS   Parenteral nutrition; Prescription review; Informatization; System

静脉营养也称肠外营养（parenteral nutrition），是临床上一种由外周或中心静脉插管输入营养物质的重要治疗方法。……