药师参与肠外营养个体化处方设计对胃癌患者术后恢复的影响

Effects of individualized parenteral nutrition designed by pharmacists on the recovery of postoperative gastric cancer patients

摘要:

目的 探讨营养专业临床药师参与胃癌术后肠外营养处方设计对患者术后恢复的影响。方法 对2019年7月1日至2019年12月31日NRS2002评分≥3分的145例胃癌术后患者进行肠外营养支持治疗，其中75例患者接受医生自主设计的肠外营养处方（对照组），70例患者接受临床药师参与制定的个体化肠外营养处方（干预组）。比较两组患者的营养指标、术后肝肾功能及电解质检测指标。结果 肠外营养治疗前，两组患者的性别、年龄、身体质量指数、手术方式、胃癌分型，以及血浆蛋白水平、肝肾功能、电解质水平均无统计学差异（P>0.05）。肠外营养治疗后，干预组患者白蛋白、前白蛋白、总蛋白水平以及血磷水平均高于对照组，差异有统计学意义（P<0.01）；丙氨酸氨基转移酶、总胆红素水平低于对照组，差异有统计学意义（P<0.05）。结论 临床药师参与胃癌术后患者的肠外营养处方设计，可提高处方的合格率，对患者术后恢复起到积极作用，保证了治疗效果。

Abstract:

Objective To investigate the influence of participation of nutrition pharmacists in the design of postoperative parenteral nutrition prescription on the recovery of gastric cancer patients.Methods A total of 145 cases of gastric cancer patients who were enrolled in our hospital between July 1, 2019 and December 31, 2019 were selected in this study. They all had gastrectomy and got NRS2002≥3 points, and all were supported by parenteral nutrition. Among them, 75 patients received parenteral nutrition prescription designed only by doctors (control group), while the other 70 patients received personalized parenteral nutrition prescription designed with the participation of clinical pharmacists (intervention group). Compare the nutritional indicators, postoperative liver and kidney function, and electrolyte indices of patients between the two groups.Results Before parenteral nutrition support, there were no statistical differences in gender, age, body mass index, operation method, classification of gastric cancer, levels of plasma proteins, liver and kidney function, electrolytes of patients between the two groups (P>0.05). After parenteral nutrition support, the levels of albumin, prealbumin and total protein of the intervention group were higher than those of the control group, and so was the blood phosphorus level (P<0.01); The alanine aminotransferase and total bilirubin levels of the intervention group were lower than those of the control group (P<0.05).Conclusion The participation of clinical pharmacists in the design of postoperative parenteral nutrition prescription not only improved the qualification rate of parenteral nutrition prescription, but also had a positive effect on the recovery of postoperative gastric cancer patients. It could ensure the treatment efficacy of patients.