一例胆管癌合并梗阻性黄疸病人肠外营养支持方案分析与调整  

Analysis and adjustment of parenteral nutritional support in a patient with bile duct cancer complicated with obstructive jaundice

作　　者：费燕[1] 王芳芳[1] 邱韵玲 

机构地区：[1]解放军第一七五医院(厦门大学附属东南医院)药学科,福建漳州363000

出　　处：《药学服务与研究》2016年第4期308-311,共4页Pharmaceutical Care and Research

摘　　要：目的:总结临床药师参与的临床肠外营养支持方案的调整。方法和结果:临床药师对1例胆管癌并梗阻性黄疸病人的肠外营养支持的适应证、用药时机、药物选择、营养素配比进行分析并提出调整建议。部分建议被临床医师采纳,病人术后经肠外营养支持9d,γ-谷氨酰转移酶(γ-GT)、碱性磷酸酶(AKP)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)及胆红素(BiL)含量逐渐降至正常,白蛋白(Alb)由术后第1天(d 1)的33.9g/L,上升至术后d 7的38.5g/L,并顺利过渡至普通流质饮食,营养支持疗效显著。结论:临床药师利用自身专业知识,参与营养支持方案的调整,促进病人用药更安全、及时、有效。Objective：To summarize the adjustment of parenteral nutritional support（PNS）participated by a clinical pharmacist.Methods and Results：The indications,medication opportunity,drug selection and nutriment proportion of PNS in the patient with bile duct cancer complicated with obstructive jaundice were analyzed and the adjustment of PNS were suggested by the clinical pharmacist.The adjustment suggestions of PNS were accepted partially by the clinicians.The levels ofγ-glutamyltransferase（γ-GT）,alkaline phosphatase（AKP）,alanine transaminase（ALT）,aspartate transaminase（AST）and bilirubin（BiL）gradually decreased to normal after the patient received postoperative PNS for 9days,and the albumin（Alb）level increased from 33.9g/L（post-operative day 1）to 38.5g/L（post-operative day 7）.The nutritional support of the patient smoothly transited to ordinary liquid diet.The efficacy of the PNS was obvious in the patient.Conclusion：Clinical pharmacists participated in the adjustment of PNS based on their expertise to promote safety,timeliness,and efficacy of medication.

关 键 词：临床药师 梗阻性黄疸 肠外营养 药学服务 

分 类 号：R977.6[医药卫生—药品] R969.3[医药卫生—药学]