目的 評(píng)價(jià)干預(yù)前后南通市第二人民醫(yī)院肝膽外科人血白蛋白的使用情況，探討其合理使用的措施。方法 選取南通市第二人民醫(yī)院肝膽外科2015年7～12月（干預(yù)前）與2016年7～12月（干預(yù)后）使用過(guò)人血白蛋白的病例，分別245、111例。比較干預(yù)前后患者的一般信息、人血白蛋白使用情況，并對(duì)其使用合理性進(jìn)行評(píng)價(jià)。結(jié)果 干預(yù)后，人血白蛋白的使用構(gòu)成比、平均用量以及平均用藥天數(shù)較干預(yù)前明顯減少，干預(yù)前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。用藥前人血白蛋白水平≥35 g/L的比例從28.6%下降至9.0%，干預(yù)前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.01）。符合白蛋白合理使用評(píng)價(jià)標(biāo)準(zhǔn)規(guī)定的適應(yīng)癥的比例由干預(yù)前的13.9%上升至干預(yù)后的56.8%，干預(yù)前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.01）；不符合適應(yīng)癥的比例由干預(yù)前的86.1%下降至干預(yù)后的43.2%，干預(yù)前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.01）。干預(yù)前后人血白蛋白的禁忌癥使用比例分別為27.8%、16.2%，干預(yù)前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。干預(yù)前人血白蛋白合理使用的比例為12.7%、干預(yù)后為50.5%，干預(yù)前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。不合理使用人血白蛋白的比例由干預(yù)前的87.3%下降至干預(yù)后的49.5%，干預(yù)前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 通過(guò)綜合干預(yù)措施，南通市第二人民醫(yī)院肝膽外科人血白蛋白的合理使用比例明顯升高，有效促進(jìn)了人血白蛋白的合理應(yīng)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.