肠外营养液处方规范化开具、审核和使用  

Standardized prescription,review,and use of parenteral nutrition solution

作　　者：陈莲珍 CHEN Lian-zhen

机构地区：[1]国家癌症中心,国家肿瘤临床医学研究中心,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：《中国实用外科杂志》2024年第2期224-229,共6页Chinese Journal of Practical Surgery

基　　金：国家重点研发计划项目(No.2016YFA0201504)。

摘　　要：肠外营养液含有氨基酸、葡萄糖、脂肪乳、电解质、微量元素、维生素等10多种营养素。为确保安全、有效,医师不但应该掌握病人的代谢营养需求,即肠外营养组分、三大宏量营养素制剂、热量及非蛋白热氮比、微量营养素以及总液体量和渗透压;还必须了解影响肠外营养液稳定性的因素,避免脂肪乳“破乳”、小分子化合物沉淀、有效成分降解和吸附等;药师也应该承担起相应的审核和配制职责,仔细审核各种营养组分的比例,使处方更加规范、配伍合理和稳定,配制顺序正确;护士作为执行者应予以正确输注和使用。此外,肠外营养治疗过程中应密切监测生化指标和并发症以保证营养液用药安全。Parenteral nutrition solution contains more than 10 types of nutrients,including amino acids,glucose,fat emulsion,electrolytes,trace elements,vitamins,etc.To ensure its safety and effectiveness,physicians should not only grasp the metabolic and nutritional needs of patients,including parenteral nutrition components,three major macronutrient preparations,calorie and nonprotein calorie to nitrogen ratio,micronutrients,total fluid volume,and osmotic pressure;It is also necessary to understand the factors that affect the stability of parenteral nutrition solution,to avoid fat emulsion cracking,small molecule compound precipitation,degradation and adsorption of active ingredients,and so on;Pharmacists should also take on responsibilities for formulation review and compounding,carefully review the proportions of various nutritional components,make prescriptions more standardized,compatible and stable,and prepare in the correct order;Nurses should infuse and use correctly.Biochemical indicators and complications should be closely monitored to ensure the safety of parenteral nutrition.

关 键 词：肠外营养 营养液 处方 营养素配比 稳定性 配伍 

分 类 号：R6[医药卫生—外科学]