本文選題：營養(yǎng)素類藥物　切入點(diǎn)：腸內(nèi)營養(yǎng)　出處：《第四軍醫(yī)大學(xué)》2014年碩士論文

【摘要】：營養(yǎng)素類藥物是指既是營養(yǎng)素又是在臨床上使用于治療和輔助治療的藥物。營養(yǎng)素（nutrient）是指食物中能給人體提供能量、構(gòu)成機(jī)體和組織修復(fù)以及具有生理調(diào)節(jié)功能的化學(xué)成分。人體所必需的營養(yǎng)素共有6類，包括蛋白質(zhì)、脂肪、碳水化物、維生素、無機(jī)鹽（礦物質(zhì)）和水。在人們的日常生活中，每天都必須有營養(yǎng)素的攝入，以維持正常的人體功能。在臨床治療中，營養(yǎng)素也可以作為藥物使用，這就是營養(yǎng)素類藥物。根據(jù)使用目的和使用方式的不同，，可以將營養(yǎng)素類藥物分為腸內(nèi)營養(yǎng)制劑、腸外營養(yǎng)制劑（靜脈營養(yǎng)制劑）和其他營養(yǎng)素類藥物。腸內(nèi)營養(yǎng)制劑主要使用于通過胃腸道消化吸收食物的緩和；腸外營養(yǎng)制劑主要用于不能通過腸道攝取、消化和吸收食物患者的營養(yǎng)支持；其它營養(yǎng)素類藥物指腸內(nèi)營養(yǎng)制劑和腸外營養(yǎng)制劑之外的營養(yǎng)素類藥物，其它營養(yǎng)素藥物有維生素、礦物質(zhì)和氨基酸等。由于營養(yǎng)素類藥物使用面廣、毒副作用小加上人們更關(guān)注營養(yǎng)保健等原因，近年來許多醫(yī)院營養(yǎng)素類藥物使用量迅速增加、價(jià)格上升、甚至出現(xiàn)了濫用和出現(xiàn)了不良反應(yīng)。 為了了解營養(yǎng)素類藥物的使用現(xiàn)狀，防止?fàn)I養(yǎng)素類藥物濫用，本文調(diào)查了某三級(jí)甲等醫(yī)院營養(yǎng)素類藥物的使用情況，并對(duì)這些藥物的使用效益進(jìn)行了分析，以便為醫(yī)生、患者和醫(yī)院管理者在選擇營養(yǎng)素類藥物時(shí)提供參考，為我國基本藥物目錄修改提供依據(jù)。 目的： 通過對(duì)某三級(jí)甲等醫(yī)院2012年全年處方進(jìn)行分析，調(diào)查營養(yǎng)素類藥物使用情況。 方法： 通過回顧性方法對(duì)某三級(jí)甲等醫(yī)院2012年全年處方進(jìn)行調(diào)查分析，用Microsoft Excel2007和SPSS16.0分析了營養(yǎng)素類藥物在該院藥品費(fèi)用中的比例；各類營養(yǎng)素類藥物的使用量、使用金額和DDDs排序；醫(yī)院不同科室使用營養(yǎng)素類藥物的情況；營養(yǎng)素類藥物導(dǎo)致的不良反應(yīng)情況等。 結(jié)果： 1、營養(yǎng)素類藥物在醫(yī)院使用藥物中占的比例為20.04%，排名第1； 2、腸外營養(yǎng)素類藥物的使用量排名第1； 3、腸內(nèi)營養(yǎng)乳劑（TP）使用量最大； 4、腸外營養(yǎng)素類藥物葡萄糖注射液使用量排名第1； 5、其他營養(yǎng)素類藥物使用量最大的是葉酸片； 6、腦外科使用營養(yǎng)素類藥物比較多； 7、營養(yǎng)素類藥物應(yīng)用年齡區(qū)間大，男女比例約為1:1； 8、使用營養(yǎng)素類藥物的患者住院時(shí)間和費(fèi)用小于不使用營養(yǎng)素類藥物的； 9、患者使用營養(yǎng)素類藥物出現(xiàn)不良反應(yīng)。 結(jié)論： 1、營養(yǎng)素類藥物已經(jīng)在臨床中得到廣泛使用； 2、腸外營養(yǎng)素類藥物使用率高； 3、腸內(nèi)營養(yǎng)素類藥物中腸內(nèi)營養(yǎng)乳劑（TP）使用量最大，金額排名第1，且DDDs排名第1，表明此藥使用頻率高； 4、腸外營養(yǎng)素類藥物中葡萄糖注射液（20ml）使用量排名第1，臨床廣泛應(yīng)用，復(fù)合磷酸氫鉀注射液（2ml）DDDs排名第1，表明此藥使用頻率高，18種氨基酸注射液（5%）金額排名第1，但其DDDs排名第四，說明使用率比較低，減輕了患者的經(jīng)濟(jì)負(fù)擔(dān)； 5、其他營養(yǎng)素類藥物中的葉酸使用率大； 6、由于患者的特殊性使得腦外科使用營養(yǎng)素類藥物比較多； 7、營養(yǎng)素類藥物在使用的過程中不區(qū)分性別和年齡，只根據(jù)病情、身體狀況等； 8、使用了營養(yǎng)素類藥物比不使用此類藥物的患者住院時(shí)間縮短，恢復(fù)更快，且醫(yī)療費(fèi)用也明顯下降； 9、盡量避免患者出現(xiàn)不良反應(yīng)。
[Abstract]:Nutrients refers to a medicine which is both nutrients and is clinically used in the treatment and adjuvant treatment . The nutrient refers to the chemical components which can provide energy to the human body in the food , form the body and tissue repair and have physiological regulating function . In the daily life of people , nutrients can be divided into enteral nutrition preparation , parenteral nutrition preparation ( intravenous nutrition preparation ) and other nutrients .
The parenteral nutrition preparation is mainly used for the nutritional support of patients who cannot ingest , digest and absorb food through the intestinal tract ;
Other nutrients such as enteral nutrition preparation and parenteral nutrition preparation have vitamins , minerals and amino acids , etc . , because the use of nutrients is wide , the toxic and side effects are small , and people pay more attention to nutrition and health care .

In order to understand the status quo of the use of nutrients and to prevent the abuse of nutrients , this article investigated the use of the nutrient drugs in a class III hospital , and analyzed the use benefit of these drugs , so as to provide references for doctors , patients and hospital administrators to provide references for the selection of nutrients and provide the basis for the revision of basic drug catalogue in our country .

Purpose :

To investigate the use of nutrients by analyzing the prescription of a Class III hospital in 2012 .

Method :

In this paper , a retrospective method was used to investigate the annual prescription of a class III hospital in 2012 , and the proportion of nutrient drugs in the drug cost of the hospital was analyzed by Microsoft Excel 2007 and SPSS 16.0 .
the use amount , the use amount and the DDDs of various kinds of nutrient drugs are sorted ;
Use of nutrient drugs in different departments of the hospital ;
Adverse reactions caused by nutrient drugs , etc .

Results :

1 . The proportion of nutrients in the use of drugs in hospitals was 20.04 % , ranking No . 1 ;


2 . The use amount of parenteral nutrition drugs is ranked as the first ;


3 . The use of enteral nutrition emulsion ( TP ) was the largest .


4 . The dosage of parenteral nutrient glucose injection is ranked as the first ;


5 . The most use of other nutrients is the leaf acid tablet .


6 . There are many kinds of nutrients in brain surgery .


7 . The age interval of the application of nutrients is large , and the proportion of male and female is about 1 : 1 ;


8 . The time and cost of hospitalization for patients with nutrients are less than those without the use of nutrients ;


9 . Adverse reactions occurred in patients using nutrients .

Conclusion :

1 . Nutrients have been widely used in clinic .


2 . The utilization rate of parenteral nutrition drugs is high ;


3 . The use of enteral nutrition emulsion ( TP ) in enteral nutrition drugs is the largest , the amount is first , and DDDs is ranked first , which shows that the use frequency of this medicine is high ;


4 . The dosage of glucose injection ( 20 ml ) in parenteral nutrition drugs was ranked as the first , clinical application , compound potassium hydrogen phosphate injection ( 2ml ) DDDs was ranked as the first , indicating that the drug use frequency was high , 18 kinds of amino acid injection ( 5 % ) were ranked first , but the DDDs ranked fourth , indicating that the utilization rate was relatively low , and the economic burden of the patient was reduced ;


5 , the use rate of folic acid in other nutrients medicaments is large ;


6 . Because of the particularity of the patients , the use of nutrients in the brain surgery is much more .


7 . The nutrient drug does not distinguish between sex and age during use , only according to the condition , physical condition , etc . ;


8 . The use of nutrient drugs is shorter than that of patients who do not use such drugs , the recovery is faster , and the medical cost is also obviously decreased ;


9 . Try to avoid the patient ' s adverse reaction .

【學(xué)位授予單位】：第四軍醫(yī)大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R95

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張潔t

本文編號(hào)：1668148