摘要
目的:探讨临床药师在胰腺围术期患者血糖控制中的作用。方法:临床药师对1例胰腺围术期需肠外营养支持的患者参考其病理生理变化特点,推荐肠外营养组方以(18AA-Ⅱ)作为氮源,在总能量供应上采用葡萄糖和脂肪混合的双能源体系,其中葡萄糖注射液供能1 105 kcal(325 g),脂肪乳注射液供能477 kcal(50 g),糖脂比为7∶3,总能量27 kcal/(kg·d),氮量0.9 g/(kg·d)。针对治疗过程中出现的血糖明显升高,药师建议应及时根据血糖变化情况增减胰岛素单独泵入的用量。2 d后,患者的血糖仍为12 mmol/L左右,药师建议将碳水化合物用量从325 g减少至200 g。结果:医师采纳药师建议,患者的血糖控制在合理范围内,有利于其术后的恢复。结论:临床药师参与营养支持治疗,可协助医师制订更加安全、有效的个体化肠外营养治疗方案,改善患者的临床结局。
OBJECTIVE：To investigate in the role of pharmacists in the blood glucose control of pancreatic perioperative patients. METHODS：For the one case of pancreatic perioperative patient who needed parenteral nutrition supporting,according to the pathological characteristics of physiological changes,clinical pharmacists recommended parenteral nutrition formula the double energy system with the toral energy supply of glucose and fat and the nitrogen source of（18AA-Ⅱ）. Glucose Injection supplied energy 1 105 Kcal（325 g）;fat emu ision injection supplied energy 477 Kcal（50 g）. Ratio between sugar and fat was 7∶3. Total energy was 27 Kcal/（kg·d）. The amount of nitrogen was 0.9 g/（kg·d）. For the obvious increase of blood sugar during the treatment process,clinical pharmacists suggested timely increasing or decreasing the dosage of single pumped insulin according to the change of blood sugar. After 2 days,patient’s blood sugar was still around 12 mmol/L. Clinical pharmacists suggested decreasing the amount of carbohydrates from 325 g to 200 g. RESULTS：Doctors adopted suggestions of clinical pharmacists. The patient’s blood sugar was controlled in a reasonable range. And this was helpful for the postoperative recovery. CONCLUSIONS：Clinical pharmacists participating the nutrition support can help doctors make safer and effective individualized parenteral nutrition treatment and improve patients’ clinical outcome.
出处
《中国药房》
CAS
北大核心
2015年第8期1129-1131,共3页
China Pharmacy
关键词
临床药师
营养支持
血糖控制
药学监护
Clinical pharmacist
Nutrition support
Blood sugar control
Pharmaceutical care
