肠衰竭相关肝病患儿营养支持及抗感染治疗的药学服务

Pharmaceutical Care for Nutritional Support and Anti-Infective Therapy in a Child with Intestinal Failure-Associated Liver Disease

目的:通过临床药师参与1例肠衰竭相关肝病患儿的临床治疗实践,探讨临床药师在肠衰竭相关肝病营养支持治疗中的作用。方法:临床药师结合肠衰竭相关肝病患儿个体情况,参与制订个体化营养支持方案和药学监护计划。结果:在临床药师和临床医师共同制定的营养支持方案下,患儿生长发育良好,胆汁淤积有所缓解,总胆红素由376.8μmol/L降至121.6μmol/L,直接胆红素由274.7μmol/L降至87.4μmol/L。结论:合理的肠内肠外营养支持治疗有利于肠衰竭相关肝病患儿维持生命,提高肠内营养耐受性,减少并发症,改善预后。

Objective:To explore the role of clinical pharmacists in nutritional support therapy through the clinical practice of a child with intestinal failure-associated liver disease.Methods:According to the individual conditions of the child,clinical pharmacists participated into formulating the individualized nutritional support and pharmaceutical care regimen.Results:Under the nutritional support regimen formulated by clinical pharmacists and clinicians,the child grew well and the cholestasis was reduced,with total bilirubin decreased from 376.8μmol/L to 121.6μmol/L and direct bilirubin decreased from 274.7μmol/L to 87.4μmol/L.Conclusion:Parenteral nutrition and enteral nutrition are beneficial to sustain life for children with intestinal failure-associated liver disease,improve intestinal tolerance,reduce the incidence of complications,and improve outcomes.