今日药学

2020, v.30(10) 707-710+714

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肠外营养液对小儿短肠综合征患者体重和生活质量等影响的回顾性分析
Retrospective Analysis of the Effects of Parenteral Nutrition on Weight and Quality of Life in Infants with Short Bowel Syndrome

邓贵华;方瑞;陈小葵;王铁桥;张琳;
DENG Guihua;FANG Rui;CHEN Xiaokui;WANG Tieqiao;ZHANG Lin;Department of Pharmacy,Guangdong Women and Children Hospital;

摘要(Abstract):

目的探讨肠外营养液对小儿短肠综合征患者体重丢失和生活质量等的影响。方法对180例短肠综合征患儿术后第一天和第七天的全肠外营养处方进行统计分析,对术后第一天和术后第七天的患儿基本信息(剩余小肠长度、胎龄、是否足月出生等)及其临床检查数据(体重、肝肾功能、并发症等)进行统计分析。结果使用肠外营养7日后,体重恢复正常有99例(55.00%),体重过高和过低分别有42例(23.33%)和39例(21.67%)。术后第1天,患儿总胆固醇异常有14例(7.78%),总胆红素异常有24例(13.33%),血糖异常有51例(28.33%),胆汁酸异常有13例(7.22%);术后第7天,患儿总胆红素异常有52例(28.89%),血糖异常有23例(12.78%),胆汁酸异常有46例(25.56%),无总胆固醇异常患儿;而在处方分析上,术后第七天成分及配比不合理的处方比术后第1天有所减少,但多种微量元素大于正常值(1 m L·kg~(-1)·d~(-1))、一价阳离子浓度异常(<130 mmol·L~(-1)或>150 mmol·L~(-1))的处方反而增加了。结论肠外营养液可以减少小儿短肠综合征患者近期体重丢失并改善患者的功能状态和生活质量,静脉调配中心的药师应加强处方审核,保障短肠综合征患儿全肠外营养的安全性和有效性。
OBJECTIVE To investigate the effect of parenteral nutrition on weight loss and quality of life in infants with short bowel syndrome. METHODS Total parenteral nutrition prescriptions,basic information( remaining small intestine length,gestational age,whether born at term,etc.) and their clinical examination data( weight,liver and renal function,complications,etc.) for 180 infants with short bowel syndrome on the first and seventh days after surgery,were collected and analyzed using method of statistics. RESULTS On the 7 th day after operation,there were 99 patients( 55.1%) returned to normal weight,42 patients( 27.3%) were excessive weight,and 39 patients( 21.7%) were in low weight. On the first day after operation,there were 14 patients( 7. 78%) with abnormal total cholesterol,24 patients( 13. 33%) with abnormal total bilirubin,51 patients( 28. 33%) with abnormal blood glucose and 13 patients( 7.22%) with abnormal bile acid. On the 7 th day after operation,there was nopatient abnormal total cholesterol,but there were 52 patients( 28.89%) with abnormal total bilirubin,23 patients( 12.78%) with abnormal blood glucose,and 46 patients( 25.56%) with abnormal bile acid. Compared with the first day after operation,on the seventh day after operation,the number of prescriptions with unreasonable composition were decreased,while the number of prescriptions with multiple trace elements more than that in normal( 1 m L·kg~(-1)·d~(-1)) and the prescriptions with abnormal concentration of monvalent cation( less than 130 mmol·L~(-1) or more than150 mmol·L~(-1)) increased. CONCLUSION Parenteral nutrition solution can reduce the recent weight loss and improve the functional status and quality of life of infants with short bowel syndrome. Pharmacists at the intravenous dispensary center should review their prescriptions to ensure the safety and effectiveness of total parenteral nutrition in children with short bowel syndrome.

关键词(KeyWords): 小儿短肠综合征;肠外营养;处方审核
short bowel syndrome in children;parenteral nutrition;prescription audit

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作者(Author): 邓贵华;方瑞;陈小葵;王铁桥;张琳;
DENG Guihua;FANG Rui;CHEN Xiaokui;WANG Tieqiao;ZHANG Lin;Department of Pharmacy,Guangdong Women and Children Hospital;

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