【摘要】 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。更多还原

【Abstract】 OBJECTIVE:To investigate the application of vitamins in parenteral nutrition(PN) prescription,and to provide reference for rational use of vitamins in PN. METHODS:Using"parenteral nutrition""intravenous nutrition""prescription analysis""rational drug use""analysis of medical order"as keywords,the literatures about the rationality analysis of PN prescriptions were retrieved from CNKI and Wanfang database during 2006-2015,and the utilization of vitamin included in literatures were analyzed and summarized. RESULTS:A total of 34 literatures were included. There were 158 874 prescriptions,among which vitamin was used in 145 400 prescriptions(91.52%). 12 or 13 kinds of vitamin were used in 73 508 prescriptions(46.27%);over-dose drug use was found in 53 388 prescriptions(33.60%),and vitamin was not completely added into 18 504 prescriptions(11.65%);no vitamin was added into 1 663 prescriptions(1.05%). The proportion of the prescriptions including 12 or 13 kinds of vitamin was the highest in northern China(52.00%). 12 or 13 kinds of vitamin were added into the prescriptions and the author believed that the proportion of excessive use of vitamin,incomplete addition of water-soluble vitamin and fat-soluble vitamin in class three grade A hospitals were all lower than hospitals below class three grade A. The prescriptions including 12 or 13 kinds of necessary vitamin were adopted in oncology department(97.72%),internal medicine department(86.62%),intensive care unit(77.99%)and surgery department(52.83%). CONCLUSIONS:The standardized use of vitamin PN prescriptions occupies low proportion in China. It is necessary to enhance the conception that multiple recommended vitamins should be added into PN.更多还原