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目的:了解我国肠外营养处方中维生素的使用情况,为我国肠外营养中维生素的合理使用提供参考。方法:以“肠外营养”或“静脉营养”和“处方分析”或“合理用药”或“医嘱分析”为关键词,检索中国知网和万方数据库中2006-2015年报道的有关肠外营养处方合理性分析文献,对纳入文献中维生素的使用情况进行分析和总结。结果:共纳入34篇文献,涉及的总处方数为158 874份,其中145 400份(91.52%)处方使用了维生素;有73 508份(46.27%)处方使用了12或13种维生素,53 388份(33.60%)处方被文献作者认为超量使用维生素,18 504份(11.65%)处方维生素添加不完全,1 663份(1.05%)处方未添加维生素。我国北部地区添加12或13种维生素的比例最高(52.00%)。“三甲”医院添加12或13种维生素、文献作者认为超量使用维生素和水溶性维生素、脂溶性维生素均未完全添加的比例均低于“三甲”以下医院。使用12或13种必需维生素比例由高到低的处方科室依次为肿瘤科(97.72%)、内科(86.62%)、重症监护病房(77.99%)和外科(52.83%)。结论:我国肠外营养处方中维生素规范使用的比例偏低,肠外营养中应添加符合推荐的多种维生素的观念仍需加强。
Objective: To understand the use of vitamins in parenteral nutrition prescriptions in our country and provide references for the rational use of vitamins in parenteral nutrition in China. Methods: The key words of “parenteral nutrition” or “parenteral nutrition” and “prescription analysis” or “rational drug use” or “doctor’s advice analysis” were used to search CNKI and Wanfang database In 2006-2015 reported on the rational analysis of parenteral nutrition literature, the use of the literature included in the analysis and summary of the use of vitamins. RESULTS: A total of 34 articles were included and the total number of prescriptions involved was 158,874, of which 145,400 (91.52%) prescriptions used vitamins; 73,508 (46.27%) prescriptions used 12 or 13 vitamins and 53,388 The prescription (33.60%) was considered excessive by the authors of the literature, while 18,504 (11.65%) of the prescribed vitamins were not completely supplemented and 1,663 (1.05%) did not. The proportion of 12 or 13 vitamins added to northern China was the highest (52.00%). “Top Three ” hospital to add 12 or 13 kinds of vitamins, literature authors believe that excess use of vitamins and water-soluble vitamins, fat-soluble vitamins are not fully added to the proportion of lower than the The department of pharmacy (97.72%), internal medicine (86.62%), intensive care unit (77.99%) and surgery (52.83%) used descending order of the 12 or 13 essential vitamins. Conclusion: The proportion of vitamin used in parenteral nutrition prescription in our country is relatively low. The concept of adding multiple vitamins that meet the recommended parenteral nutrition should be strengthened.