临床药师干预前后急性胰腺炎患者营养支持应用分析

Analysis on Application of Nutritional Support on Acute Pancreatitis Before and After the Intervention Implemented by Clinical Pharmacists

目的:比较临床药师干预前后福建省立医院急性胰腺炎(acute pancreatitis,AP)患者营养支持的使用情况。方法:临床药师通过培训、参与查房等形式对AP患者营养支持情况进行干预,设计《福建省立医院消化内科急性胰腺炎营养支持调查表》,采集患者的基本信息、疾病情况、实验室指标和营养支持情况等信息,并采用营养风险筛查表(utrition risk screening,NRS)2002对患者进行营养风险筛查及评估。结果:与干预前比较,干预后NRS 2002评分<3分的患者单瓶肠外营养使用率明显降低,全肠外营养使用率明显升高,差异均有统计学意义(P<0.05);干预后NRS 2002评分≥3分的患者单瓶肠外营养使用率明显降低,差异有统计学意义(P<0.05)。中度AP和重度AP患者肠内营养及全肠外营养使用率均较干预前明显降低,差异有统计学意义(P<0.05)。干预前,AP患者平均腹痛持续时间为(8.70±5.83)d,干预后缩短至(5.83±4.0)d,差异有统计学意义(P<0.05);干预前后患者住院时间的差异无统计学意义(P>0.05)。结论:临床药师对AP患者营养支持情况进行干预,可改善AP患者营养支持现状,促进临床合理用药。

OBJECTIVE：To compare the application of nutritional support on acute pancreatitis （ AP） before and after the intervention implemented by clinical pharmacists in Fujian Provincial Hospital . METHODS：Clinical pharmacists conducted intervention on nutritional support of AP patients through training and ward round , and the＂Questionnaire about Nutritional Support on Acute Pancreatitis in Department of Gastroenterology in Fujian Provincial Hospital＂ was designed to collect patients＆#39; general information, illness, laboratory indices, nutritional support, etc. And utrition risk screening （ NRS ） 2002 was adopted in nutritional risk screening and assessment on patients . RESULTS：Compared with before intervention , usage rate of single bottle parenteral nutrition （ PN ） among patients scored 〈3 in utrition risk screening （ NRS） 2002 was significantly decreased after intervention , and the usage rate of TPN was significantly increased , with statistically significantly difference （ P〈0.05 ）; usage rate of single bottle PN among patients score ≥3 in NRS 2002 was significantly decreased after intervention , with statistically significantly difference （ P 〈0.05 ） .The usage rates of EN and TPN among MSAP and SAP patients had been significantly decreased than those of before intervention , with statistically significantly difference （P〈0.05）.Before intervention, the mean duration time of stomachache among AP patients was （8.70 ±5.83） d, which decreased to （5.83 ±4.0） d after intervention , with statistically significantly difference （ P〈0.05 ）; there was no statistical significance in the difference of hospital stays between two groups before and after intervention （ P 〉0.05 ） .CONCLUSIONS：The intervention of nutritional support on AP patients implemented by clinical pharmacists can significantly improve the current situation of nutrition support of AP patients and promote clinical rational medication .