药物治疗管理在结直肠肿瘤病人围手术期营养支持治疗中的实践  

Practice of medication therapy management in the nutrition support during the perioperative period of colorectal cancer patients

作　　者：赵阳昱[1] 朱忠华[1] ZHAO Yangyu;ZHU Zhonghua(Department of Pharmacy,Huangshan People's Hospital,Huangshan,Anhui 245000,China)

机构地区：[1]黄山市人民医院药剂科,安徽黄山245000

出　　处：《安徽医药》2023年第9期1881-1885,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的评价临床药师运用药物治疗管理参与结直肠肿瘤病人围手术期营养支持治疗的效果,探索临床药师如何运用药物治疗管理为结直肠肿瘤病人围手术期提供更满意的药学服务。方法选取2019年1月至2020年3月黄山市人民医院收治的100例行结直肠癌根治术的病人,采用随机数字表法分为对照组和试验组,各50例。对照组由临床医师和护士负责病人的围手术期营养治疗管理,试验组由临床药师应用药物治疗管理对病人围手术期营养治疗进行干预。比较两组病人术后营养状况,临床疗效,治疗依从性和不良反应发生率。结果与对照组相比,试验组病人术后第7天营养指标血红蛋白,白蛋白、视黄醇结合蛋白水平提高,炎症指标C反应蛋白水平降低(P<0.05);术后7 d营养风险发生率试验组(8/50,16%)低于对照组(18/50,36%)(P<0.05);试验组术后出现并发症发生率(7/50,14%)和药物不良反应发生率(4/50,8%)低于对照组(22/50,44%)(15/50,30%)(P<0.05);治疗依从性良好率试验组(42/50,84%)优于对照组(18/50,36%)(P<0.05);住院天数试验组(18.22±4.71)d少于对照组(22.58±8.45)d(P<0.05)。结论药物治疗管理在围手术期病人营养支持治疗中的应用,可以有效改善病人围手术期营养情况,提高用药依从性,降低药物不良反应发生率,促进病人术后早期康复。Objective To systematically evaluate the impact of medication therapy management on the nutrition support during the perioperative period of colorectal cancer,and to explore how clinical pharmacists use medication therapy management to provide satisfactory pharmaceutical service for patients with colorectal cancer.Methods A total of 100 patients with colorectal cancer admitted to the Huangshan People's Hospital from January 2019 to March 2020 were enrolled and randomly assigned into the experiment group(n=50)and the control group(n=50)by random number table method.In the control group,patients were routinely treated by doctors and nurses and the other patients in the experiment group were given additional medication therapy management by clinical pharmacists to provide a full pharmacy service.A comparison was made between the two groups of the nutrition status,clinical outcomes,medication adherence,and the incidence of adverse drug reactions.Results On the 7th day after operation,the nutritional indexes haemoglobin,serum albumin and retinol binding protein in the experiment group were higher than those in the control group,while the inflammatory index C-reactive protein was lower in the experiment group than the control group(P<0.05);on the 7th day after operation,the rate of nutritional risk in the experiment group(8/50,16%)was lower than that of the control group(18/50,36%)(P<0.05);the rate of postoperative complications(7/50,14%)and incidence of adverse drug reactions(4/50,8%)were lower in the experiment group than the control group(22/50,44%)(15/50,30%)(P<0.05);the rate of treatment adherence(42/50,84%)was higher in the experiment group than the control group(18/50,36%)(P<0.05);average hospital stay(18.22±4.71)d was lower in the experiment group than the control group(22.58±8.45)d(P<0.05).Conclusion Medication therapy management in the nutrition support during the perioperative period of colorectal cancer patients can improve nutrition status and medication adherence,reduce incidence of adverse drug reactio

关 键 词：药物疗法管理 营养支持 围手术期 结直肠肿瘤 

分 类 号：R735.3[医药卫生—肿瘤]