商品化多腔袋与个体化全合一肠外营养液临床应用比较

Clinical Utility of Commercial Standardized Multi-chamber Bags and Customized Compound Total Parenteral Nutrition Admixture

关键词:  住院患者  肠外营养  临床效果  费用分析

Key words:  hospitalized patients  parenteral nutrition  clinical outcome  cost analysis

摘要:

目的 对比成人住院患者使用商品化多腔袋与个体化全合一肠外营养液的临床效果差异。方法 回顾2017年6月1日—2018年5月31日期间入住安徽医科大学第三附属医院（合肥市第一人民医院）且进行肠外营养支持的患者，收集其住院费用、手术费用、总药物费用、营养药物费用、抗菌药物费用、肝肾功能指标、电解质、血糖、住院时间和肠外营养支持时间等数据，分析比较商品化多腔袋与个体化全合一肠外营养支持的临床使用效果。结果 共纳入患者50例，其中个体化组25例，商品化组25例。2组临床疗效相当。个体化组总胆红素水平比用药前出现了升高，而商品化组总胆红素水平比用药前出现了降低。变化情况存在显著性差异。肠外营养支持费用存在显著性差异[个体化组（1 278.3±1 164.0）元，商品化组（3 396.4±3 313.2）元，P=0.004]。结论 对于成人住院患者，个体化全合一肠外营养制剂与商品化多腔袋肠外营养制剂在营养支持临床效果方面差异不显著。但个体化组对患者胆红素水平的影响小于商业化组。个体化与商品化多腔袋在治疗成本方面存在显著性差异，提示临床在制定肠外营养药物治疗方案时应综合疗效、不良反应、药物经济学等多方面资料综合考虑。

Abstract:

OBJECTIVE To compare the clinical effects of commercial standardized multi-chamber bags(s-TPN) and customized total parenteral nutrition admixture(c-TPN) in adult hospitalized patients. METHODS The patients who were admitted to the Third Affiliated Hospital of Anhui Medical University(Hefei First People's Hospital) and supported by parenteral nutrition therapy were collected from June 1, 2017 to May 31, 2018. Collected data on hospitalization costs, surgery costs, total drug costs, nutrient medication costs, antibacterial medication costs, liver and kidney function indicators, electrolytes, blood glucose, hospital stay, and parenteral nutrition support time. So as to analyze and compare the clinical use effect of s-TPN and c-TPN. RESULTS Total of 50 patients were enrolled, including 25 in the s-TPN group and 25 in the c-TPN group. The clinical efficacy of the two groups was equivalent. The level of total bilirubin in c-TPN group was higher than that before medication, while in s-TPN group it was lower. There was a significant difference in parenteral nutrition support costs as well[c-TPN group (1 278.3±1 164.0) yuan, s-TPN group(3 396.4±3 313.2) yuan, P=0.004]. CONCLUSION For adult hospitalized patients, there is no significant difference in the clinical effects of s-TPN and c-TPN. However, the effect of the c-TPN group on the level of Tbil in patients is smaller than that in the s-TPN group. There are significant differences in the cost of treatment between the two groups. It is suggesting that comprehensive consideration shall be given to the efficacy, adverse reactions, pharmacoeconomics and other data in the selection of different parenteral nutrition therapy plan.