目的 了解鄂東醫(yī)療集團(tuán)高齡產(chǎn)婦剖宮產(chǎn)術(shù)后圍手術(shù)期腸外營(yíng)養(yǎng)藥的使用情況，為合理使用腸外營(yíng)養(yǎng)藥提供參考。方法 隨機(jī)抽取2016年1月—2018年6月鄂東醫(yī)療集團(tuán)行剖宮產(chǎn)術(shù)圍手術(shù)期使用腸外營(yíng)養(yǎng)藥高齡產(chǎn)婦的臨床病歷，對(duì)用藥頻度（DDDs）、藥物利用指數(shù)（DUI）、日均費(fèi)用（DDC）進(jìn)行統(tǒng)計(jì)分析，并分析其臨床用藥合理性。結(jié)果 2016—2018年高齡產(chǎn)婦剖宮產(chǎn)術(shù)圍手術(shù)期人均藥品費(fèi)用和腸外營(yíng)養(yǎng)藥的費(fèi)用均逐年下降，但腸外營(yíng)養(yǎng)藥占藥品總費(fèi)用的比例逐年上升，共涉及10種腸外營(yíng)養(yǎng)藥。注射用脂溶性維生素（Ⅱ）、注射用水溶性維生素和復(fù)方氨基酸注射液（18AA-V）的DDDs位于前3位，臨床選擇性較高；大多數(shù)藥物的DUI接近于1.0，說明用藥基本合理，但注射用脂溶性維生素（Ⅱ）和注射用水溶性維生素的DUI＞1.0，可能存在超劑量用藥。氨基酸注射液（5%）的DDC最大，患者經(jīng)濟(jì)負(fù)擔(dān)較重；高齡產(chǎn)婦剖宮產(chǎn)術(shù)后圍手術(shù)期存在腸外營(yíng)養(yǎng)藥物不合理用藥，主要表現(xiàn)為無適應(yīng)癥用藥、超療程用藥、超劑量用藥、維生素類藥物用藥不規(guī)范等，其中以無適應(yīng)癥用藥最常見。結(jié)論 鄂東醫(yī)療集團(tuán)高齡產(chǎn)婦剖宮產(chǎn)術(shù)后圍手術(shù)期腸外營(yíng)養(yǎng)藥的使用基本合理，但仍存在不合理用藥現(xiàn)象，需要繼續(xù)加強(qiáng)規(guī)范化合理用藥。

Objective To analyze the utilization of parenteral nutrition drugs in elderly parturient women after caesarean section in Edong Healthcare, and to provide the basis methods for rational drug use of parenteral nutrition drugs.Methods Clinical records of elderly parturient women after caesarean section in Edong Healthcare who used the parenteral nutrition drugs from January 2016 to June 2018 in Edong medical group were randomly selected. Defined daily dose system (DDDs), drug use index (DUI), and average defined daily cost (DDC) were analyzed statistically, and rationality of clinical medication was analyzed. Results From 2016 to 2018, the per capita cost and total cost of parenteral nutrition drugs were both decreased year by year in the perioperative period of cesarean section, but the proportion of the cost of parenteral nutrition drugs to the total drug cost was increased year by year. There were ten parenteral nutrition drugs used. DDDs of Fat-soluble Vitamin for injection (Ⅱ), Water-Soluble Vitamin for injection, and Compound Amino Acid Injection (18AA-V) were respectively ranked the top three, indicating they had high clinical selectivity. DUI of most drugs were close to 1.0, indicating that the drugs were basically reasonable, but DUI of Fat-soluble Vitamin for injection (Ⅱ) and Water-soluble Vitamin for injection were over 1.0, indicating they may had super dose medication. DDC of Amino Acid Injection (5%) was the largest, and indicating that patient's economic burden were heavy. The irrational use of parenteral nutrition drugs mainly manifested in non adaptation drugs, super medication, super dose of drug use, not standardized use of vitamin drugs and so on, among which no indications was common. Conclusion The application of parenteral nutrition drugs in patients of elderly parturient women after caesarean section is reasonable on the whole, but there is some unreasonable use, therefore the management of its standardization should be strengthened.

黃石市醫(yī)藥衛(wèi)生科研立項(xiàng)項(xiàng)目（[2015]3號(hào)）