肠外营养处方糖脂比合理范围重要性探讨  

Discussion on importance of reasonable range of sugar-to-fat ratio in parenteral nutrition prescriptions

作　　者：聂婧栩[1] 崔凯霞 祁雪妍 郝志英[1] 陈莲珍 NIE Jing-xu;CUI Kai-xia;QI Xue-yan;HAO Zhi-ying;CHEN Lian-zhen(Department of Pharmacy,Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030000,Shanxi,China;School of Pharmaceutical Sciences,Shanxi Medical University,Taiyuan 030001,Shanxi,China;Department of Pharmacy,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]山西省肿瘤医院/中国医学科学院肿瘤医院山西医院/山西医科大学附属肿瘤医院药学部,山西太原030000 [2]山西医科大学药学院,山西太原030001 [3]国家癌症中心/国家肿瘤临床医学中心/中国医学科学院北京协和医学院肿瘤医院药剂科,北京100021

出　　处：《肠外与肠内营养》2023年第5期257-261,共5页Parenteral & Enteral Nutrition

基　　金：国家重点研发计划项目(2016YFA0201504);山西省重点研发计划(指南)项目(201603D321105)。

摘　　要：目的:探讨临床实践中因肠外营养糖脂比不合理导致的相关用药安全性问题,为临床营养药物的合理应用提供依据。方法:从建库开始截至2023年2月28日,检索国内外相关数据库,对纳入文献及笔者在临床实践中遇到的不合理糖脂比处方导致的临床不良结局进行汇总和分析。结果:共纳入11篇文献,另有笔者通过调整不合理的糖脂比,病人不适好转病例1例。共涉及86例病人,男性51例,女性35例。年龄最小18岁,最大89岁。86例病人共发生临床不良结局79次,其中共有死亡病例8例,临床不良结局发生率分别为:肝功能异常46.8%(37/79)、胆汁淤积22.8%(18/79)、脂肪超载综合征13.9%(11/79)、肝脂肪变性11.4%(9/79)、血小板减少3.8%(3/79)、其它1.3%(1/79)。86例病人中,明确记载的有2例病人通过调整糖脂比后,临床不良结局得到改善,其他不详。结论:不适宜的糖脂比可能导致肠外营养相关用药的安全性问题,应引起临床重视。Objective:To explore the medication safety issues caused by unreasonable sugar-to-fat ratio in clinical practice of parenteral nutrition,providing a basis for the rational use of clinical nutritional drugs.Methods:From the beginning of the database construction until February 28,2023,relevant databases at home and abroad were searched to summarize and analyze the clinical adverse outcomes caused by unreasonable sugar-to-fat ratio prescriptions encountered in the included literature and clinical practice.Results:Eleven articles were included,and 1 case of patient discomfort was improved by adjusting the unreasonable sugar-to-fat ratio.A total of 86 patients were involved,including 51 males and 35 females,with an age range of 18 to 89 years.Among the 86 patients,there were 79 clinical adverse outcomes,including 8 deaths.The incidence rates of clinical adverse outcomes were as follows:abnormal liver function 46.8%(37/79),bile stasis 22.8%(18/79),fat overload syndrome 13.9%(11/79),liver steatosis 11.4%(9/79),platelet reduction 3.8%(3/79),and other 1.3%(1/79).Among the 86 patients,2 cases were clearly recorded to have improved clinical adverse outcomes after adjusting the sugar-to-fat ratio,and the others were not detailed.Conclusions:Inappropriate sugar-to-fat ratio may lead to safety issues related to parenteral nutrition medication and should be given clinical attention.

关 键 词：肠外营养 糖脂比 合理应用 

分 类 号：R459.3[医药卫生—治疗学]