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临床药师参与胰十二指肠切除围手术期营养管理的效果评价
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| 篇名： | 临床药师参与胰十二指肠切除围手术期营养管理的效果评价 |
| TITLE： | Evaluation of clinical pharmacists participating in the perioperative nutritional management of pancreaticoduode-nectomy |
| 摘要： | 目的 探讨临床药师参与胰十二指肠切除术（PD）围手术期营养规范管理对患者预后的影响。方法回顾性分析2019年11月－2021年2月在南京大学医学院附属鼓楼医院胆胰外科行PD的100例患者的临床资料，按围手术期营养管理方案的不同，将其分为临床药师干预组（n＝51，临床药师根据营养管理规范流程进行干预）和对照组（n＝49，临床药师仅术前进行营养评估，临床医师根据患者病情进行营养支持），评价两组患者术后恢复指标、经济性评价指标、住院时长、术后并发症、术后肠内营养支持途径等结局指标的差异。结果临床药师干预组患者术后恢复流质饮食时间、术后首次通气时间、术后首次通便时间、腹腔引流管拔出时间均显著早于对照组（P＜0.05），住院费用、药物费用、营养支持费用、肠外营养费用、白蛋白制剂费用、术后住院天数均显著低于/短于对照组（P＜0.05）；两组患者术后并发症发生率差异无统计学意义（P＞0.05）；两组患者围手术期肠内营养支持途径比较，差异有统计学意义（P＜0.05）。结论临床药师参与PD围手术期营养管理可显著降低患者的住院费用、营养支持费用，改善患者围手术期的营养状况、缩短其住院时间。 |
| ABSTRACT： | OBJECTIVE To explore the role of clinical pharmacists participating in the standardized perioperative nutritional management process for pancreaticoduodenectomy （PD） on improving postoperative recovery in patients. METHODS The clinical data of 100 patients undergoing PD in the Department of Biliary and Pancreatic Surgery， Drum Tower Hospital Affiliated to Nanjing University School of Medicine from November 2019 to February 2021 were analyzed retrospectively. According to the different perioperative nutrition management plans， they were divided into clinical pharmacist intervention group （n＝51， clinical pharmacists intervened according to the standardized nutrition management process） and control group （n＝49， clinical pharmacists only performed preoperative nutrition evaluation， and clinical physicians took nutrition support according to the patient’s condition）. The differences in postoperative recovery index， economic evaluation index， hospitalization length， postoperative complications， and postoperative enteral nutrition support route were compared between 2 groups. RESULTS The time of postoperative diet， the first postoperative ventilation， the first postoperative defecation， and postoperative drainage time of abdominal drain were significantly earlier in the clinical pharmacist intervention group than in the control group （P＜0.05）； the hospitalization cost， medication cost， nutritional support cost， parenteral nutrition cost， albumin preparation cost， and the length of postoperative hospitalization were significantly lower/shorter in the clinical pharmacist intervention group than in the control group （P＜0.05）； there was no statistically significant difference in the incidence of postoperative complications between the two groups （P＞0.05）； there was statistically significant difference in the perioperative enteral nutrition support pathways between two groups （P＜0.05）. CONCLUSIONS Clinical pharmacists’ participation in perioperative nutritional management for PD can significantly reduce hospitalization costs and nutritional support costs， improve patients’ perioperative nutritional status， and shorten hospital stays. wanglina668@163.com |
| 期刊： | 2024年第35卷第05期 |
| 作者： | 王黎娜；卞晓洁；蒋绍艳；邓少洁；仇毓东；毛谅；葛卫红 |
| AUTHORS： | WANG Lina，BIAN Xiaojie，JIANG Shaoyan，DENG Shaojie，QIU Yudong，MAO Liang，GE Weihong |
| 关键字： | 胰十二指肠切除术；围手术期；临床药师；营养管理 |
| KEYWORDS： | pancreaticoduodenectomy； perioperative； clini- |
| 阅读数： | 54 次 |
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