临床药师参与肠外营养支持干预对肝胆胰手术住院患者的影响

Q4 Nursing

中华临床营养杂志 Pub Date : 2019-08-30 DOI:10.3760/CMA.J.ISSN.1674-635X.2019.04.005

Ruoning Qu, Q. Yu, Zong-liang Yang

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Nutritional risk, parenteral nutrition support indications, parenteral nutrition prescription energy and amino acid supply, prescription incompatibility and rationality, prescription osmotic concentration and phlebitis, parenteral nutrition and drugs in Y-tube compatibility of the above patients were analyzed to evaluate the effect of interventions by clinical pharmacists after participating in the nutritional support team. \n \n \nResults \nPatients with benign pancreatic diseases in the two groups had higher incidence of nutritional risk (78.2%, 75.6%), and patients with benign biliary diseases had lower incidence of nutritional risk (76.4%, 69.9%). Incidence of patients having parenteral nutrition support indications, namely NRS 2002≥3 points was higher in intervention group (83.6%) than in control group (56.6%); parenteral nutrition prescription energy and amino acid supply were higher in intervention group than in control group, patients in the intervention group had lower blood albumin dosage and no over-indication medication than patients in the control group; patients in both groups had no parenteral nutrition prescription safety issues such as glycolipid ratio (kJ∶kJ) 0.05). 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引用次数: 0

摘要

目的评价临床药师在肠外营养支持干预中的作用，为临床药师参与ERAS营养支持小组工作模式提供参考。方法选择2016年11月至2017年1月在我院肝胆胰外科住院的患者490例作为对照组。选择2018年11月至2019年1月在我院肝胆胰外科住院的521例患者作为干预组。分析上述患者的营养风险、肠外营养支持指征、肠外营养处方能量与氨基酸供应、处方配伍与合理性、处方渗透浓度与静脉炎、肠外营养与y管内药物配伍情况，评价临床药师参与营养支持团队后干预的效果。结果两组胰腺良性疾病患者营养风险发生率较高(78.2%，75.6%)，胆道良性疾病患者营养风险发生率较低(76.4%，69.9%)。干预组患者有肠外营养支持指征(NRS 2002≥3分)的发生率(83.6%)高于对照组(56.6%);干预组患者肠外营养处方能量和氨基酸供应高于对照组，干预组患者血白蛋白用量低于对照组，无超指征用药;两组患者均无糖脂比(kJ∶kJ) 0.05等肠外营养处方安全性问题。干预组肠外营养液与y管药物的配伍性低于对照组。结论临床药师参与ERAS营养治疗团队，协助医生制定营养治疗方案，监测患者的营养支持情况，并定期进行室内培训，可有效提高肠外营养支持的合理应用，规范治疗药物的使用，指导患者及护理人员安全使用制剂，确保患者在临床干预中的安全。关键词:肝胆胰外科;临床药师;营养风险;肠外营养支持;全营养添加剂

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Effect of clinical pharmacists participating in parenteral nutrition support intervention in patients hospitalized in hepatobiliary and pancreatic surgery

Objective To evaluate the effect of clinical pharmacists on parenteral nutrition support interventions, and to provide reference for clinical pharmacists to participate in the ERAS Nutrition Support Group work model. Methods A total of 490 patients hospitalized in department of hepatobiliary and pancreatic surgery from November 2016 to January 2017 were selected as control group. 521 patients hospitalized in department of hepatobiliary and pancreatic surgery from November 2018 to January 2019 were selected as intervention group. Nutritional risk, parenteral nutrition support indications, parenteral nutrition prescription energy and amino acid supply, prescription incompatibility and rationality, prescription osmotic concentration and phlebitis, parenteral nutrition and drugs in Y-tube compatibility of the above patients were analyzed to evaluate the effect of interventions by clinical pharmacists after participating in the nutritional support team. Results Patients with benign pancreatic diseases in the two groups had higher incidence of nutritional risk (78.2%, 75.6%), and patients with benign biliary diseases had lower incidence of nutritional risk (76.4%, 69.9%). Incidence of patients having parenteral nutrition support indications, namely NRS 2002≥3 points was higher in intervention group (83.6%) than in control group (56.6%); parenteral nutrition prescription energy and amino acid supply were higher in intervention group than in control group, patients in the intervention group had lower blood albumin dosage and no over-indication medication than patients in the control group; patients in both groups had no parenteral nutrition prescription safety issues such as glycolipid ratio (kJ∶kJ) 0.05). The compatibility of parenteral nutrition solution and drug in Y-tube was lower in the intervention group than in the control group. Conclusion The participation of clinical pharmacist in the ERAS nutrition treatment team, who will assist the doctor in formulating the nutritional treatment plan, monitor the patient's nutritional support and conduct regular indoor training, can effectively improve the reasonable application of parenteral nutrition support, standardize the use of therapeutic drugs, and guide patients and caregivers to use the preparations safely so that to ensure patients' safety in clinical interventions. Key words: Department of hepatobiliary and pancreatic surgery; Clinical pharmacist; Nutritional Risk; Parenteral nutrition support; Total nutrition admixture

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来源期刊

中华临床营养杂志 Nursing-Nutrition and Dietetics

CiteScore

0.20

自引率

0.00%

发文量

2282

期刊介绍： The Chinese Journal of Clinical Nutrition was founded in 1993. It is the first professional academic journal (bimonthly) in my country co-sponsored by the Chinese Medical Association and the Chinese Academy of Medical Sciences to disseminate information on clinical nutrition support, nutrient metabolism, the impact of nutrition support on outcomes and "cost-effectiveness", as well as translational medicine and nutrition research. It is also a professional journal of the Chinese Medical Association's Parenteral and Enteral Nutrition Branch. The purpose of the Chinese Journal of Clinical Nutrition is to promote the rapid dissemination of knowledge on nutrient metabolism and the rational application of parenteral and enteral nutrition, focusing on the combination of multidisciplinary and multi-regional field investigations and clinical research. It mainly reports on nutritional risk screening related to the indications of parenteral and enteral nutrition support, "cost-effectiveness" research on nutritional drugs, consensus on clinical nutrition, guidelines, expert reviews, randomized controlled studies, cohort studies, glycoprotein and other nutrient metabolism research, systematic evaluation of clinical research, evidence-based case reports, special reviews, case reports and clinical experience exchanges, etc., and has a special column on new technologies related to the field of clinical nutrition and their clinical applications.