临床药师对消化道肿瘤患者术后全营养混合液组方的干预研究

目的探讨临床药师参与消化道肿瘤患者肠外营养支持并提供个体化全营养混合液(TNA)组方对患者的影响。方法回顾性分析87例行消化道肿瘤切除术患者的临床资料,分为临床药师参与会诊并提供个体化TNA组方的干预组(23例)与临床药师未参与治疗的对照组(64例),比较两组患者术前1 d、术后1 d及5 d的血清总蛋白(TP)、血清白蛋白(ALB)、前白蛋白(PA)与淋巴细胞计数(LYM)的测定值,以及术后并发症、住院时间等。结果干预组术后5 d各营养学指标较术后d1有显著增加(P<0.05);干预组术前1 d各营养学指标较对照组术前1 d无显著性差异(P>0.05),而术后5 d较对照组术后5 d有显著增加(P<0.05);干预组的住院时间(10.8±2.2)d显著低于对照组(14.9±2.4)d(P<0.05);干预组术后并发症与对照组相比无显著性差异(P>0.05)。结论临床药师参与消化道肿瘤患者肠外营养支持并提供药学服务,可以较好地改善患者机体营养状态,提高康复效果。

Clinical pharmacist's intervention study of total nutrition admixture composition in gastrointestinal cancer patients undergoing surgery treatment

Objective To investigate the effect of clinical pharmacist＇ s participation of parenteral nutrition support in gastrointestinal cancer patients undergoing surgery treatment and intervention of individual total nutrition admixture composition. Methods Retrospective analysis was made of the clinical information of 87 gastrointestinal cancer patients undergoing surgery treatment, who were divided into two groups ： Intervention group （ n = 23 ）, consultation by clinical pharmacist to provide individual total nutrition admixture composition; control group （n = 64）, clinical pharmacists not involved in nutrition support. Total serum protein （TP）, serum albumin （ALB）, prealbumin （ PA ）, lymphocyte counts （ LYM ）, postoperative complications and hospital stay were recorded and compared in both groups. Results In intervention group nutrition index in d5 after operation was statistically significantly higher than that in dl after oper- ation （ P 〈 0.05 ）. The nutrition index was not significantly different between intervention group and control group in dl before operation （ P 〉 0.05 ）, while nutrition index in d5 after operation in intervention group is statistically significant higher than control group in d5 after operation （P 〈0.05） ; the hospital stay of intervention group （ 10.8 ± 2.2） d is statistically significant lower than that of control group （ 14.9± 2.4 ） d （ P 〈 0.05 ）, while the postoperative complications was not significantly different between intervention group and control group （P 〉 0.05 ）. Conclusion That the clinical pharmacists involve in parenteral nutrition support of gastrointestinal patients undergoing operation and provide pharmaceutical care can improve nutritional status and rehabilitation effect of patients.