临床药师参与制订1例T细胞淋巴瘤患者化疗期间营养支持方案的分析

Analysis of Clinical Pharmacists Participating in the Formulation of Nutritional Support Program for a Case of T-cell Lymphoma during Chemotherapy

目的:探讨临床药师在T细胞淋巴瘤患者化疗期间营养支持中发挥的作用,为营养支持在恶性肿瘤患者中的临床应用提供参考。方法:临床药师根据病情变化对1例T细胞淋巴瘤患者营养支持方案进行制订与调整:减少TPN中20%中/长链脂肪乳注射液(C6-24)用量至125 ml,10%浓氯化钠至6 g,同时加用整蛋白型肠内营养剂(粉剂)口服营养支持,并加用丁二磺酸腺苷蛋氨酸保肝治疗,并对患者实施药学监护。结果:9 d后,患者由全肠外营养支持过渡至全肠内营养支持,营养状况改善,继续行下一步化疗方案。结论:临床药师参与到临床治疗团队中,协助医师制订和调整营养支持方案,并加强药学监护,可以确保营养支持的安全、有效。

OBJECTIVE： To investigate the role of clinical pharmacists on nutritional support for a T-cell lymphoma patients dur ing chemotherapy, and to provide reference for the clinical application of nutritional support in patients with malignant tumors. METH- ODS： The clinical pharmacists developed and adjusted the nutritional support program according to the changes of disease and provid ed the pharmaceutical care for a patient with T-cell lymphoma： the amount of 20% Medium and long chain fat emulsion injection （C6-24） was decreased to 125 ml in TPN, 10% Concentrated sodium chloride to 6 g, adding High energy enteral nutritional polymer ic diet （powder） and liver protection therapy of ademetioninel, 4-butanedisulfonate. RESULTS ： 9 days later, total parenteral nutrition support was changed to full enteral nutritional support, and the nutritional status of patient was improved, the next step chemotherapy could be continued. CONCLUSIONS： Clinical pharmacists participate in the clinical treatment team, develop and adjust nutritional support program and strengthen the pharmaceutical care to ensure the safety and effectiveness of nutritional support.