外科药房静脉用药集中调配中心全肠外营养液医嘱分析

目的：对外科药房静脉用药集中调配中心全肠外营养液不合理医嘱进行分析，了解不合理用药的情况，提高临床用药的安全性、合理性、有效性。方法：对外科药房静脉用药集中调配中心2012年1-12月全部TPN不合理医嘱常见问题进行审核，对其中不合理TPN的典型医嘱进行整理和分析。结果：不合理TPN医嘱主要问题集中在TPN的药物组成、药物溶媒、离子浓度、给药剂量、液体量、重复用药、配伍禁忌与不良相互作用、能量配比等方面。结论：药师应立足于药房、静脉用药集中调配中心，为临床提供更加可靠的用药信息，通过医嘱审查联络信的方式与临床科室进行沟通，确保患者用药安全、合理。

Analysis of medical orders of total parenteral nutrition in pharmacy intravenous admixture services of surgery pharmacy

Objective：To investigate the irrational medical orders of total parenteral nutrition （TPN） in order to improve the safety, effectiveness and rationality of drug use. Methods：All the irrational TPN medical orders of PIVAS from Jan. 2012 to Dec. 2012 were checked, classiifed and statistically analyzed. Results：The main problems of the irrational TPN medical orders were the drug composition, solvent, ion concentration, administration dosage, lfuid volume, repeated administration, incompatibility, adverse drug interactions and the energy matching, etc. Conclusion：Pharmacists should provide reliable information to the clinic, communicate with the clinic through contact letters, so as to make contributions to ensure the rational and safe use of drugs.