肠外营养处方辅助开具程序的研发及临床应用

摘要/Abstract

摘要： 目的：介绍临床药师设计研发的肠外营养(PN)处方辅助开具程序，并调研其对PN处方合理性的影响。方法：基于Excel设计研发了PN处方辅助开具程序，通过我院住院电子病历系统抽取10例需要PN治疗的患者，为其开具处方，比较医师人工计算和使用程序辅助计算开具处方的速度和正确率。回顾性调研我院肿瘤科2019年1～5月和2019年7～11月使用PN的病例各100份，点评处方合理性，统计分析程序的使用对肿瘤科PN处方合理性的影响。结果：相比于医师人工计算，使用程序辅助计算开具PN处方的速度和正确率都有提高。该程序在肿瘤科试用后，2019年7～11月科室PN处方合理率由使用前2019年1～5月的57%提高至94%，使用该程序前后PN处方的能量供给、热氮比、糖脂比、丙氨酰谷氨酰胺占比、渗透压的合理性差异均存在统计学意义(P＜0.05)。结论：PN处方辅助开具程序的使用提高了医师开具PN处方的速度和正确率，促进了PN的合理使用。

关键词: font-size:medium, ">肠外营养；处方开具程序；合理性；临床药师

Abstract: Objective： To introduce the computer-aided parenteral nutrition(PN) prescribing application and investigate its effect on the rationality of PN prescriptions. Methods： Based on the Microsoft Excel， clinical pharmacists developed the computer-aided PN prescribing application. 10 patients needing PN support were extracted randomly from HIS system， the PN prescriptions were completed by physician manually or using computer-aided application， and the speed and accuracy of the two ways were analyzed and compared. A retrospective survey was conducted on PN prescriptions including 100 cases prescribed from January to May 2019 and 100 cases prescribed from July to November 2019 in oncology department， and the prescriptions were reviewed to analyze the change in rate of rational PN prescriptions before and after the use of computer-aided application. Results： Compared to manual valuation， the speed and accuracy of computer-aided application assisted valuation were significantly improved. After the use of computer-aided application， the rate of rational PN prescriptions in oncology department increased from 57% to 94%， specifically there were significant differences in the total energy supply， the ratio of heat to nitrogen， the ratio of glucose to lipid， alanylglutamine proportion and osmotic pressure(P＜0.05). Conclusion： The use of computer-aided PN prescribing application improved work efficiency of physician and promoted the rational use of PN.

Key words: font-size:medium, ">Parenteral nutrition； Computer-aided prescribing； Rationality； Clinical pharmacist

中图分类号:

公静, 杨海, 张洁婷, 刘雪丽. 肠外营养处方辅助开具程序的研发及临床应用[J]. 中国医药导刊, 2021, 23(1): 49-53.

GONG Jing, YANG Hai, ZHANG Jieting, LIU Xueli. Development and Clinical Application of Computer-aided Parenteral Nutrition Prescribing[J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2021, 23(1): 49-53.

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