神经外科围手术期使用复方氨基酸注射液（14AA-SF）的合理性和经济性评价 点击下载
| 论文标题： | 神经外科围手术期使用复方氨基酸注射液（14AA-SF）的合理性和经济性评价 |
| 英文标题： | |
| 中文摘要： | 目的 建立复方氨基酸注射液（14AA-SF）（以下简称“14AA-SF”）合理用药标准，并对其合理性和经济性进行评价。方法基于德尔菲法建立14AA-SF合理用药标准。随机抽取亳州市人民医院神经外科2024年1月至2025年12月使用14AA-SF的患者病历，在所建合理用药标准基础上，应用属性层次模型对病历中14AA-SF的使用情况进行合理性评价。应用决策树模型计算增量-成本效果比（ICER），评价14AA-SF单瓶输注与“全合一”输注方式的经济性，并通过敏感性分析来验证经济性评价结果的稳健性。结果共抽取205份病历，其中病历评分（MRS）≥90分的合格病历有163份（占79.51%），MRS＜90分的不合格病历有42份（占20.49%）；14AA-SF使用不合理的类型主要表现为输注方式不合理（67例次，占32.68%）、氨基酸用量不合理（62例次，占30.24%）以及非蛋白热氮比不合理（55例次，占26.83%）等。与单瓶输注相比“，全合一”输注每增加1%的有效率，对应的增量成本为165.40元。单因素敏感性分析显示，单瓶输注有效率对ICER的影响最大。概率敏感性分析显示，在本研究设定的意愿支付（WTP）阈值（89358元）下“，全合一”输注相对于单瓶输注的经济性概率为89.9%；当WTP阈值超过17871.60元时“，全合一”输注比单瓶输注更具有经济性。结论所建14AA-SF合理用药标准切实可行。该院神经外科在适应证、营养风险筛查、输注方式等方面存在不合理使用14AA-SF的现象，需进一步规范“；全合一”输注比单瓶输注更具有经济性。 |
| 英文摘要： | OBJECTIVE To establish standards for the rational use of Compound amino acid injection （14AA-SF） （hereinafter referred to as “14AA-SF”）， and evaluate its rationality and cost-effectiveness.METHODS The standards for the rational use of 14AA-SF were established based on the Delphi method. Archived medical records of patients who used 14AA-SF in the Dept. of Neurosurgery of People’s Hospital of Bozhou from January 2024 to December 2025 were randomly selected. On the basis of the established standards for the rational use， the attribute hierarchical model was applied to evaluate the use rationality of 14AA-SF in the included medical records. The decision tree model was applied to calculate the incremental cost-effectiveness ratio （ICER）， so as to evaluate the cost-effectiveness of 14AA-SF administered via single-bottle infusion versus “all-in-one” infusion， and the robustness of the cost-effectiveness evaluation results was verified through sensitivity analysis.RESULTS A total of 205 medical records were collected， among which 163 records （79.51%） were qualified with medical record score （MRS） ≥90， and 42 records （20.49%） were unqualified with MRS ＜90. The main irrational types of 14AA-SF use included unreasonable infusion method （67 case-times， accounting for 32.68%）， unreasonable amino acid dosage （62 case-times， accounting for 30.24%） and unreasonable non-protein calorie-nitrogen ratio （55 case-times， accounting for 26.83%）. Compared wtih single-bottle infusion， the incremental cost of “all-in-one” infusion for each 1% increase in effective rate was 165.40 yuan. The one-way sensitivity analysis showed that the effective rate of single-bottle infusion had the greatest impact on ICER. The probabilistic sensitivity analysis showed that under the willingness-to-pay （WTP） threshold （89 358 yuan） set in this study， the cost-effectiveness probability of “all-in-one” infusion relative to single-bottle infusion was 89.9%. When the WTP threshold exceeds 17 871.60 yuan， the “all-in-one” infusion is more cost-effective than the single-bottle infusion.CONCLUSIONS The established standards for the rational use of 14AA-SF are practical and feasible. There are phenomena of irrational use of 14AA-SF in Dept. of Neurosurgery of the hospital in terms of indications， nutritional risk screening， infusion methods and other aspects， which need to be further standardized. The “all-in-one” infusion is more cost-effective than the single-bottle infusion. |
| 期刊： | 2026年第37卷第17期 |
| 作者： | 梁海；王静静；陈慧娟；夏茹楠；狄潘潘；姜梦雨；李璠琴；马景贺 |
| 英文作者： | LIANG Hai，WANG Jingjing，CHEN Huijuan，XIA Runan，DI Panpan，JIANG Mengyu，LI Fanqin，MA Jinghe |
| 关键字： | 复方氨基酸注射液（14AA-SF）；合理用药；经济性；营养治疗；属性层次模型；神经外科；围手术期 |
| KEYWORDS： | rational drug use;cost-effectiveness;nutritional therapy;attribute hierarchical model;neurosurgery;perioperative period |
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