高翔,吴海燕,元刚,陈杰,任斌,陈孝
GAO Xiang,WU Haiyan,YUAN Gang,CHEN Jie,REN Bin,CHEN Xiao

• 1:中山大学附属第一医院药学部

摘要(Abstract)：

目的评价本院入住重症医学科患者管饲给药的合理性及影响因素。方法采用回顾性分析方法,调查2012-10-10~2012-11-09期间入住本院重症医学科包括外科重症监护室(SICU)、内科重症监护室(MICU)、神经科重症监护室(NICU)40例患者的管饲给药情况,对患者的用药合理性进行评价分析。结果 40例患者均采用经鼻饲管给药,通过鼻饲管给药的药物共有79个品种,共使用3 182次,平均每人使用80次,同一时间给药品种最高可达11种。剂型包括普通片、缓控释片、胶囊、肠溶片、口服液等,不合理应用合计253例次。主要存在问题包括将肠溶片(27例次)经研磨后注入胃管造成药物在胃内失活,缓控释片(80例次)研碎后管饲给药造成药物峰浓度偏高,软胶囊(31例次)胃管给药造成剂量定量不准确等。结论由于医护人员药物专业知识的不足,临床管饲给药存在不合理情况,临床药师应发挥药学专业知识进一步规范合理化管饲给药。
OBJECTIVE To evaluate the rationality of medication through enteral feeding tube in intensive care unit and its influencing factors. METHODS A total of 40 patients administered drugs through enteral feeding tube from October 10,2012 to November 9,2012 in the surgical intensive care unit( SICU),medical intensive care unit( MICU) and the neurosurgical intensive care unit( NICU) were reviewed. Their medications and administration procedures were evaluated and analyzed. RESULTS 79 kinds of drugs( used 3182 times) were administered through nasal feeding tube in all the patients. The varieties of drugs used at the same time were up to 11 kinds. Drugs were available as film tablets,controlled release tablets,capsules,enteric-coated tablets and oral liquid.Unreasonable formulation application included grinding enteric-coated tablets( used 27 times) which causes drug inactivation in the stomach,crushing slow-release tablets( used 80 times) which causes high peak concentration and adverse reactions,and squeezing soft capsules( used 31 times) which casuses in drug dose inaccuracy. CONCLUSION Unreasonable medication given through enteral feeding tubes might occur due to the inadequate pharmaceutical expertise of health care practitioners. Clinical pharmacists should participate in standardize and rationalize the procedures.

关键词(KeyWords)： 管饲;重症医学科;临床药师;合理用药
enteral feeding;intensive care unit;clinical pharmacist;rational medication

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 高翔,吴海燕,元刚,陈杰,任斌,陈孝
GAO Xiang,WU Haiyan,YUAN Gang,CHEN Jie,REN Bin,CHEN Xiao

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