目的 评价干预前后南通市第二人民医院肝胆外科人血白蛋白的使用情况，探讨其合理使用的措施。方法 选取南通市第二人民医院肝胆外科2015年7～12月（干预前）与2016年7～12月（干预后）使用过人血白蛋白的病例，分别245、111例。比较干预前后患者的一般信息、人血白蛋白使用情况，并对其使用合理性进行评价。结果 干预后，人血白蛋白的使用构成比、平均用量以及平均用药天数较干预前明显减少，干预前后比较差异具有统计学意义（P<0.05）。用药前人血白蛋白水平≥35 g/L的比例从28.6%下降至9.0%，干预前后比较差异具有统计学意义（P<0.01）。符合白蛋白合理使用评价标准规定的适应症的比例由干预前的13.9%上升至干预后的56.8%，干预前后比较差异有统计学意义（P<0.01）；不符合适应症的比例由干预前的86.1%下降至干预后的43.2%，干预前后比较差异有统计学意义（P<0.01）。干预前后人血白蛋白的禁忌症使用比例分别为27.8%、16.2%，干预前后比较差异有统计学意义（P<0.05）。干预前人血白蛋白合理使用的比例为12.7%、干预后为50.5%，干预前后比较差异具有统计学意义（P<0.05）。不合理使用人血白蛋白的比例由干预前的87.3%下降至干预后的49.5%，干预前后比较差异具有统计学意义（P<0.05）。结论 通过综合干预措施，南通市第二人民医院肝胆外科人血白蛋白的合理使用比例明显升高，有效促进了人血白蛋白的合理应用。

Objective To evaluate the usage of human serum albumin in Hepatobiliary Surgery of Nantong Second People's Hospital before and after intervention, so as to explore rational and effective interventions. Methods Patients (245 and 111 cases) in Hepatobiliary Surgery of Nantong Second People's Hospital from July to December 2015 (before intervention) and July to December 2016 (after intervention) were respectively selected. General information of patients, usage of human serum albumin before and after intervention was compared, and the rationality of albumin before and after intervention was evaluated. Results After intervention, the constituent ratio, average dosages, and average duration were significantly decreased, and there was significant difference between those before and after intervention (P < 0.05). The level of human serum albumin ≥ 35 g/L before medication decreased from 28.6% to 9.0%, and there was significant difference between those before and after intervention (P < 0.05). The proportion of indications according to the standard of rational use of albumin increased from 13.9% to 56.8%, and there was significant difference between those before and after intervention (P < 0.01). While the ratio that does not meet the indications decreased from 86.1% to 43.2%, and there was significant difference between those before and after intervention (P < 0.01). The ratios of contraindications were 27.8% and 16.2%, respectively, with significant difference between before and after intervention (P < 0.05). The ratio of rational use of albumin before intervention was 12.7%, while 50.5% after intervention, and there was significant difference between those before and after intervention (P < 0.05). The ratio of unreasonable use of albumin decreased from 87.3% before intervention to 49.5% after intervention, with significant difference (P < 0.05). Conclusions The rate of rational drug use is significantly increased in Hepatobiliary Surgery of Nantong Second People's Hospital by comprehensive intervention measures, in order to effectively promote clinical rational drug use of human serum albumin.