食管癌术后再发吞咽困难患者营养治疗的药学监护

Pharmaceutical care of the nutrition therapy for a patient with recurrent dysphagia after endoscopic resection of esophageal cancer

1例79岁老年男性患者,因“食管癌术后1年,伴进行性吞咽困难半年,加重2 d”入院,诊断为食管癌术后(食管狭窄)、高血压。入院后给予抑酸护胃、预防韦尼克脑病、肠外肠内营养支持等治疗。临床药师对该患者进行全程药学监护,在营养支持方案的确定与调整、再喂养综合征与韦尼克脑病的预防、肠内营养制剂的选择以及家庭营养支持方面进行深入分析,提出用药建议,与医生积极沟通、协助治疗。经过营养治疗21 d后,患者恢复良好带管出院。

A 79-year-old male patient was admitted to the hospital because of 1 year after endoscopic resection of esophageal cancer,progressive dysphagia for half a year and aggravation for 2 days.He was diagnosed with post esophageal cancer surgery(esophageal stenosis)and hypertension.After admission,he was given the treatment including acid inhibition and stomach protection,Wernicke’s encephalopathy prevention,parenteral and enteral nutrition support,etc.Clinical pharmacists carried out the wholeprocess pharmaceutical care for the patient,and gave medication suggestions after deeply analyzing the nutritional support methods,formulation and adjustment of parenteral nutrition programs,prevention of refeeding syndrome and Wernicke’s encephalopathy,selection of enteral nutrition preparations,and family nutritional support regimen.Clinical pharmacists actively communicated with the doctor and assisted in treatment.The patient recovered well and was discharged with a tube after 21 days.