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目的通过对胃癌术后并发乳糜性腹水患者营养支持方案的优化干预和药学监护,探讨临床药师在合理用药中的作用。方法临床药师对乳糜性腹水的高龄患者术前术后的营养支持方案进行全程药学监护。临床药师对术前营养支持方案、术后早期营养支持方式以及出现并发症(乳糜腹水)时营养支持方案的调整进行干预。结果具有营养风险的高龄患者术前可在饮食基础上口服标准整蛋白型制剂,术后出现乳糜性腹水时采用无脂饮食可使腹水消退。结论临床药师参与营养支持治疗,可协助医师制定更加安全、有效的个体化营养支持方案,减轻术后并发症,缩短住院时间。
Objective To explore the role of clinical pharmacists in rational drug use by optimizing interventions and pharmacological monitoring of nutrition support for patients with postoperative gastric cancer complicated with chylous ascites. Methods Clinical pharmacists carried out full-scale pharmacy care on the nutritional support of elderly patients with chylous ascites before and after surgery. Clinical pharmacists intervened with preoperative nutrition support programs, early postoperative nutritional support modalities, and adjustment of nutritional support programs when complications (chylomicrrhinis) occurred. Results The nutritional risk of elderly patients can be preoperative oral standard protein-based preparations on the basis of oral, chylous ascites postoperative use of non-fat diet can make ascites subside. Conclusion The participation of clinical pharmacists in nutritional support therapy can help physicians develop safer and more effective individualized nutrition support plans, reduce postoperative complications and shorten the hospital stay.