以营养药师为主导的营养支持团队在肝硬化失代偿期患者中的实践  

Practice of nutritional support teams led by nutritional pharmacists in patients with decompensated cirrhosis

作　　者：杨香瑜[1] 陈露 胡乃毅[2] 胡伟[2] 张韶辉[1] YANG Xiang-yu;CHEN Lu;HU Nai-yi;HU Wei;ZHANG Shao-hui(Department of Pharmacy,The First Hospital of Wuhan,Wuhan 430022;Department of Gastroenterology,The First Hospital of Wuhan,Wuhan 430022)

机构地区：[1]武汉市第一医院药学部,武汉430022 [2]武汉市第一医院消化内科,武汉430022

出　　处：《中南药学》2023年第11期3079-3084,共6页Central South Pharmacy

基　　金：湖北省卫生健康委员会科研项目(No.WJ2021M005);湖北省卫生健康委员会科研项目(No.WJ2019F037)。

摘　　要：目的建立以营养药师为主导的营养支持团队,探究其在肝硬化失代偿期患者中的实践效果。方法选择2021年6月至2022年6月在我院消化内科确诊住院治疗的肝硬化失代偿期患者,结合患者就诊顺序及意愿进行分组,分为干预组和对照组。干预组采取以营养药师为主导的营养支持团队进行营养管理,对照组采取传统模式进行营养管理。分别比较两组患者基线资料、营养管理临床指标和药学指标。结果干预组患者白蛋白、血红蛋白、总淋巴细胞计数水平均高于对照组(P<0.01),Child-Pugh评分及患者半年内再入院次数低于对照组(P<0.01),平均住院日、出院前血氨水平低于对照组,但差异无统计学意义。干预组患者营养制剂使用率高于对照组(P<0.01),营养支持方案不合理使用率低于对照组(P<0.01),但两组患者的不良反应发生率无明显差异。结论通过建立以营养药师为主导的营养支持团队,可提高肝硬化失代偿期患者营养支持的效果,同时保证营养支持方案的合理使用,以期帮助患者更好地改善营养状态。Objective To establish a nutritional support team led by nutritional pharmacists to determine the practical effect on patients with decompensated cirrhosis.Methods Patients with decompensated cirrhosis admitted to the Department of Gastroenterology in our hospital from June 2021 to June 2022 were divided into an intervention group and a control group based on patient visit order and willingness.The intervention group received nutrition support from the team led by nutritional pharmacists for nutrition management,while the control group adopted the traditional mode for nutrition management.Baseline data,nutritional management clinical indexes and pharmaceutical indexes of both groups were compared.Results The albumin level,hemoglobin level and total lymphocyte count in the intervention group were higher than those in the control group(P<0.01),the Child-Pugh score and the number of readmissions in half a year was lower than that in the control group(P<0.01),and the average hospitalization days and blood ammonia level before the discharge were lower than those in the control group,without significant difference.The utilization rate of nutritional preparations in the intervention group was higher than that in the control group(P<0.01).and the irational utilization rate of nutritional support programs was lower than that in the control group(P<0.01),but there was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Establishing a nutritional support team led by nutritional pharmacists helps improve the effect of nutritional support on patients with decompensated cirrhosis,and ensure the rational use of nutritional support,which ultimately improve patients'nutritional status.

关 键 词：营养药师 营养支持团队 肝硬化失代偿期 

分 类 号：R473.5[医药卫生—护理学]