人血白蛋白在烧伤患者中应用的循证医学评价程娟.pdfVIP

人血白蛋白在烧伤患者中应用的循证医学评价 程娟 吴华* (合肥市滨湖医院药学部，安徽省，合肥市，230601) 摘要：目的 运用循证医学方法，分析我院烧伤患者人血白蛋白（human serum albumin,HSA ） 使用情况，评价其应用的合理性，以期促进临床合理用药。方法 系统回顾烧伤患者中应用 HSA 的相关研究，并进行质量评价。分析本院2014 年1-6 月HSA 的使用情况。 结果 目 前的循证医学证据对烧伤患者液体复苏、低蛋白血症的治疗不支持使用 HSA ，但对烧伤后 （12-24h ）内HSA 在液体复苏方面的应用尚存争议。16 名患者中，烧伤后0-12h 内未使用 HSA ；12-24h 有6 人使用HSA ，均为重症烧伤患者；16 名患者均使用HSA 纠正低蛋白血 症。结论 本院烧伤科HSA 用于休克液体复苏基本合理，但应用HSA 纠正休克后期低蛋白 血症现象较普遍，与目前的循证医学证据不符。 关键词：循证医学；血清白蛋白；烧伤；液体治疗；休克；低蛋白血症 Evidence-based medicine assessment of the application of human serum albumin in burn patients * Cheng Juan, WU Hua (Dept. of Pharmacy ,Hefei Binhu Hospital，Anhui Hefei 230601 ，China) ABSTRACT ：OBJECTIVE Take the evidence-based medicine approach,to investigated and evaluated the rationality of the usage of Human serum albumin(HSA )in burned patients in our hospital ,and in order to promote the rational use of HSA. METHOD Systematic review the related studies about application of HSA in burn patients,and then evaluated the quality. We also retrospective investigate and analyse the HSA usage on patients who admitted in our hostpital burn department during January-June.period of 2014. RESULT The current evidence-based medicine on the fluid resuscitation and hypoalbuminemia of burn patients does not support the use of HSA. But whether HSA can be initiated during the 12-24 hours post burn remains controversy. None of the 16 patients in our hospital, who were between 0-12 hours post burn(PB), used the HSA; but in the 12-24 hours PB, 6 patients with severe burn used HSA. All the 16 patients used HSA for the correction of hypoalbuminemia. CONCLUSION In our hospital burn department, the use of HSA for burn sh