目的 了解鄂东医疗集团高龄产妇剖宫产术后围手术期肠外营养药的使用情况，为合理使用肠外营养药提供参考。方法 随机抽取2016年1月—2018年6月鄂东医疗集团行剖宫产术围手术期使用肠外营养药高龄产妇的临床病历，对用药频度（DDDs）、药物利用指数（DUI）、日均费用（DDC）进行统计分析，并分析其临床用药合理性。结果 2016—2018年高龄产妇剖宫产术围手术期人均药品费用和肠外营养药的费用均逐年下降，但肠外营养药占药品总费用的比例逐年上升，共涉及10种肠外营养药。注射用脂溶性维生素（Ⅱ）、注射用水溶性维生素和复方氨基酸注射液（18AA-V）的DDDs位于前3位，临床选择性较高；大多数药物的DUI接近于1.0，说明用药基本合理，但注射用脂溶性维生素（Ⅱ）和注射用水溶性维生素的DUI＞1.0，可能存在超剂量用药。氨基酸注射液（5%）的DDC最大，患者经济负担较重；高龄产妇剖宫产术后围手术期存在肠外营养药物不合理用药，主要表现为无适应症用药、超疗程用药、超剂量用药、维生素类药物用药不规范等，其中以无适应症用药最常见。结论 鄂东医疗集团高龄产妇剖宫产术后围手术期肠外营养药的使用基本合理，但仍存在不合理用药现象，需要继续加强规范化合理用药。

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.

黄石市医药卫生科研立项项目（[2015]3号）