滇西地区某三甲医院静脉输液使用现状分析

Analysis of the Current Status of Intravenous Infusion Use in a Tertiary Hospital in Western Yunnan

摘要: 目的：本研究旨在通过对某医院静脉输液使用情况的分析，为临床安全、有效、合理用药提供数据支持与参考依据。方法：采用回顾性与趋势性分析方法，统计并分析医院就诊量、静脉输液使用情况、各项用药变化以及用药安全信息等，以判断其变化趋势的合理性。结果：我院静脉输液使用呈现科室特异性：重症医学科(17.40袋/床日)和急诊ICU (16.51袋)用量显著高于均值(5.82 ± 3.21袋)(P < 0.001)，外科科室(如普外科7.5袋)高于内科(如内分泌科2.1袋) (P = 0.003)。住院输液率(TS = −0.03)和人均输液量(TS = −0.01)同比下降，反映合理用药成效。抗菌药物使用平稳(TS = 0.00)，但抑酸类药物显著上升(TS = 0.02)；肠外营养中单瓶输注锐减(TS = −0.04)，全合一使用仍低(6.27%)。需重点关注重症及外科科室输液规范，优化抑酸类药物及肠外营养管理。结论：医院静脉输液存在监管不足、原则执行不严、认知误区及药学监护欠缺等问题。建议加强监管、规范使用原则、提升合理用药认知、强化药学监护，以优化输液管理。

Abstract: Objective: This study aims to provide data support and reference for the safe, effective, and rational use of drugs in clinical practice by analyzing the use of intravenous infusion in a hospital. Methods: A retrospective and trend analysis approach was adopted to statistically analyze the hospital’s patient visits, intravenous infusion usage, changes in drug use, and drug safety information, in order to assess the rationality of the trends. Results: The use of intravenous infusion in our hospital showed department-specific characteristics: the intensive care unit (17.40 bags per bed-day) and emergency ICU (16.51 bags) had significantly higher usage than the average (5.82 ± 3.21 bags) (P < 0.001), and surgical departments (e.g., general surgery, 7.5 bags) had higher usage than internal medicine departments (e.g., endocrinology, 2.1 bags) (P = 0.003). The intravenous infusion rate for inpatients (TS = −0.03) and the average infusion volume per person (TS = −0.01) decreased year-on-year, reflecting the effectiveness of rational drug use. The use of antimicrobial agents remained stable (TS = 0.00), while the use of acid-suppressing drugs increased significantly (TS = 0.02). In parenteral nutrition, the use of single-bottle infusion decreased sharply (TS = −0.04), and the use of all-in-one infusion remained low (6.27%). It is necessary to focus on the standardization of intravenous infusion in intensive care and surgical departments, and to optimize the management of acid-suppressing drugs and parenteral nutrition. Conclusion: There are problems in the hospital’s intravenous infusion management, such as insufficient supervision, poor implementation of principles, misconceptions, and lack of pharmaceutical care. It is recommended to strengthen supervision, standardize the principles of use, improve the awareness of rational drug use, and enhance pharmaceutical care to optimize intravenous infusion management.