1例极低出生体质量儿伴坏死性小肠结肠炎营养支持治疗的药学监护

目的通过对1例极低出生体质量儿并发坏死性小肠结肠炎(necrotizing enterocolitis,NEC)患儿营养支持方案的优化干预和药学监护,探讨临床药师在营养支持治疗中发挥的作用。方法对患儿初始肠外营养支持方案进行优化,在患儿并发NEC及出现肠外营养相关的高甘油三酯血症时,及时对营养支持方案的调整进行干预。结果出生后24h内给予氨基酸是安全的。当患儿出现NEC时予以禁食,全肠外营养支持;当出现高甘油三酯血症时应减少脂肪乳用量。结论患儿营养支持方案的制定与调整做到了个体化,使营养支持治疗达到较好的效果。

Pharmaceutical Care of Clinical Nutrition Treatment for a Very Low Birth Weight Infant with Necrotizing Enterocolitis

OBJECTIVE To explore the role of clinical pharmacists in nutrition support treatment by optimizing intervention and providing pharmaceutical care for the nutritional supportive program for a very low birth weight infant with necrotizing enterocolitis (NEC). METHODS The initial parenteral nutrition support program for the very low birth weight infant was optimized, and the nutritional support program was timely adjusted when the infant was complicated with NEC and hypertriglyceridemia associated with parenteral nutrition. RESULTS It is safe to give amino acids in 24h after birth. When the infant is diagnosed with NEC, she or he should be fasted and supported with parenteral nutrition totally instead. When symptom of high triglycerides develops, the amount of fat emulsion should be reduced. CONCLUSION The formulation and adjustment of infant''s nutritional support program should be individualized to achieve a more satisfactory therapeutic effect.