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临床药师参与胰十二指肠切除围手术期营养管理的效果评价
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王黎娜 1， 2＊ ，卞晓洁 ，蒋绍艳 ，邓少洁 ，仇毓东 ，毛 谅 ，葛卫红（1. 深圳市妇幼保健院药剂科，广东 深圳
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518028；2.南京大学医学院附属鼓楼医院药学部，南京 210008；3.南京大学医学院附属鼓楼医院胰腺与代谢
外科，南京 210008）
中图分类号 R619；R975 文献标志码 A 文章编号 1001-0408（2024）05-0618-05
DOI 10.6039/j.issn.1001-0408.2024.05.19

摘 要 目的 探讨临床药师参与胰十二指肠切除术（PD）围手术期营养规范管理对患者预后的影响。方法 回顾性分析2019年
11月－2021年2月在南京大学医学院附属鼓楼医院胆胰外科行PD的100例患者的临床资料，按围手术期营养管理方案的不同，
将其分为临床药师干预组（n＝51，临床药师根据营养管理规范流程进行干预）和对照组（n＝49，临床药师仅术前进行营养评估，临
床医师根据患者病情进行营养支持），评价两组患者术后恢复指标、经济性评价指标、住院时长、术后并发症、术后肠内营养支持途
径等结局指标的差异。结果 临床药师干预组患者术后恢复流质饮食时间、术后首次通气时间、术后首次通便时间、腹腔引流管拔
出时间均显著早于对照组（P＜0.05），住院费用、药物费用、营养支持费用、肠外营养费用、白蛋白制剂费用、术后住院天数均显著
低于/短于对照组（P＜0.05）；两组患者术后并发症发生率差异无统计学意义（P＞0.05）；两组患者围手术期肠内营养支持途径比
较，差异有统计学意义（P＜0.05）。结论 临床药师参与PD围手术期营养管理可显著降低患者的住院费用、营养支持费用，改善患
者围手术期的营养状况、缩短其住院时间。
关键词 胰十二指肠切除术；围手术期；临床药师；营养管理

Evaluation of clinical pharmacists participating in the perioperative nutritional management of
pancreaticoduodenectomy
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WANG Lina ，BIAN Xiaojie ，JIANG Shaoyan ，DENG Shaojie ，QIU Yudong ，MAO Liang ，GE Weihong 2
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（1. Dept. of Pharmacy， Shenzhen Maternity and Child Healthcare Hospital， Guangdong Shenzhen 518028，
China；2. Dept. of Pharmacy， Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University，
Nanjing 210008， China；3. Dept. of Pancreatic and Metabolic Surgery， Nanjing Drum Tower Hospital Affiliated
to Medical School of Nanjing University， Nanjing 210008， China）
ABSTRACT OBJECTIVE To explore the role of clinical pharmacists participating in the standardized perioperative nutritional
management process for pancreaticoduodenectomy （PD） on improving postoperative recovery in patients. METHODS The clinical
data of 100 patients undergoing PD in the Department of Biliary and Pancreatic Surgery， Drum Tower Hospital Affiliated to
Nanjing University School of Medicine from November 2019 to February 2021 were analyzed retrospectively. According to the
different perioperative nutrition management plans， they were divided into clinical pharmacist intervention group （n＝51， clinical
pharmacists intervened according to the standardized nutrition management process） and control group （n＝49， clinical pharmacists
only performed preoperative nutrition evaluation， and clinical physicians took nutrition support according to the patient’s
condition）. The differences in postoperative recovery index， economic evaluation index， hospitalization length， postoperative
complications， and postoperative enteral nutrition support route were compared between 2 groups. RESULTS The time of
postoperative diet， the first postoperative ventilation， the first postoperative defecation， and postoperative drainage time of
abdominal drain were significantly earlier in the clinical pharmacist intervention group than in the control group （P＜0.05）； the
hospitalization cost， medication cost， nutritional support cost， parenteral nutrition cost， albumin preparation cost， and the length of
postoperative hospitalization were significantly lower/shorter in the clinical pharmacist intervention group than in the control group
（P＜0.05）； there was no statistically significant difference in the incidence of postoperative complications between the two groups
（P＞0.05）； there was statistically significant difference in the perioperative enteral nutrition support pathways between two groups
（P＜0.05）. CONCLUSIONS Clinical pharmacists’ participation in perioperative nutritional management for PD can significantly
reduce hospitalization costs and nutritional support costs，
Δ 基金项目 南京大学中国医院改革发展研究院培育课题（No.
improve patients’ perioperative nutritional status， and shorten
NDYG2022051）
＊第一作者 药师，硕士。研究方向：围手术期营养管理。E-mail： hospital stays.
wanglina668@163.com KEYWORDS pancreaticoduodenectomy； perioperative； clini-
# 通信作者 副主任药师。研究方向：肠内营养与肠外营养。 cal pharmacist； nutritional management
E-mail：18061678828@189.cn

· 618 · China Pharmacy 2024 Vol. 35 No. 5 中国药房 2024年第35卷第5期