临床药师参与肠外营养相关性肝损害患者治疗的药学监护 点击下载
论文标题: 临床药师参与肠外营养相关性肝损害患者治疗的药学监护
英文标题:
中文摘要: 目的:探讨临床药师在肠外营养相关性肝损害(PNALD)患者的临床营养治疗中的作用,促进临床营养药物的合理应用。方法:临床药师参与1例PNALD患者的治疗过程,建议将原有的“全合一”营养液配方中的5%葡萄糖氯化钠注射液500 mL调整为0.9%氯化钠注射液500 mL,30%长链脂肪乳剂250 mL调整为20%中/长链脂肪乳剂250 mL,8.5%复方氨基酸注射液(18AA)1 000 mL调整为8%复方氨基酸注射液(15AA)750 mL,并加用20%丙氨酰谷氨酰胺注射液100 mL和10% ω-3鱼油脂肪乳注射液100 mL,其余配方不变。另加用保肝药物还原型谷胱甘肽、S-腺苷蛋氨酸进行保肝退黄治疗,并逐渐减少肠外营养(PN)的量,过渡到肠内营养(EN)。结果:医师采纳临床药师的调整建议,该患者的肝功能逐渐恢复正常。结论:PN使用时间,PN中脂质种类、摄入量,营养物过剩等是造成PNALD的主要因素。临床药师在患者的临床营养治疗中开展药学监护可确保营养药物安全、有效地利用,减少并发症及药物不良反应的发生。
英文摘要: OBJECTIVE: To explore the role of clinical pharmacists in the clinical nutrition therapy for patients with parenteral nutrition-associated liver dagame (PNALD), and to promote the rational use of nutrition drugs. METHODS: Clinical pharmacists participated in the treatment of a case of PNALD, and suggested adjusting 5% Glucose and sodium chloride injection 500 mL to 0.9% Sodium chloride injection 500 mL, 30% Long-chain triglycerides 250 mL to 20% Medium/long chain fatty emulsion 250 mL, 8.5% Compound amino acid injection (18 AA) 1 000 mL to 8% Compound amino acid injection (15 AA) 750 mL; additionally using 20% Alanyl glutamine injection 100 mL and 10% ω-3 Fish oil fat emulsion injection 100 mL in “all in one” parenteral nutrition (PN) formula. The remaining recipes remain unchanged. Reduced glutathione and S-methionine were also adopted for protecting liver and receding jaundice, and the amount of PN was decreased gradually and replaced by enteral nutrition (EN). RESULTS: Physicians adopted the suggestions of clinical pharmacists, and liver function of the patient recovered to normal. CONCLUSIONS: Main factors of PNALD include medication time of PN, types and intake of lipid, over nutrition. Clinical pharmacists provide pharmaceutical care in nutritional treatment for patients, which can assure effective and safe use of nutritional drugs, and reduce the occurrence of complication and ADR.
期刊: 2017年第28卷第17期
作者: 魏来,赵春景
英文作者: WEI Lai,ZHAO Chunjing
关键字: 临床药师;肠外营养相关性肝损害;临床营养治疗;药学监护
KEYWORDS: Clinical pharmacist; Parenteral nutrition-associated liver damage; Clinical nutrition therapy; Pharmaceutical care
总下载数: 81次
本日下载数: 2次
本月下载数: 81次
文件大小: 619.60Kb

* 注:未经本站明确许可,任何网站不得非法盗链资源下载连接及抄袭本站原创内容资源!在此感谢您的支持与合作!