中国药物应用与监测
中國藥物應用與鑑測
중국약물응용여감측
CHINESE JOURNAL OF DRUG APPLICATION AND MONITORING
2015年
3期
157-159
,共3页
临床药师%溃疡性结肠炎%营养支持%血栓%脂肪乳
臨床藥師%潰瘍性結腸炎%營養支持%血栓%脂肪乳
림상약사%궤양성결장염%영양지지%혈전%지방유
Clinical pharmacist%Ulcerative colitis%Nutrition support%Thrombus%Fat emulsion
1例30岁男性患者,因“腹泻半月、解黏液脓血便一周”入院,诊断为溃疡性结肠炎(急性,初发型,重度,全结肠,活动期)。入院第7天患者解鲜血便5次,量约800 mL,伴有乏力、心慌、冷汗,BP 86/50 mm Hg,P 100次·min-1,予禁食、暂停肠内营养及对症处理。临床药师协助医生拟定肠外营养支持方案,患者使用肠外营养第2天、颈内静脉置管术后3 h输注其他静脉液体后突发剧烈右侧胸痛,不能排除导管栓塞或疾病本身导致的肺栓塞、心肌梗死,立即对肠外营养做出调整:暂停使用脂肪乳。经过13 d的肠外营养支持,患者病情明显好转并恢复经口摄入。
1例30歲男性患者,因“腹瀉半月、解黏液膿血便一週”入院,診斷為潰瘍性結腸炎(急性,初髮型,重度,全結腸,活動期)。入院第7天患者解鮮血便5次,量約800 mL,伴有乏力、心慌、冷汗,BP 86/50 mm Hg,P 100次·min-1,予禁食、暫停腸內營養及對癥處理。臨床藥師協助醫生擬定腸外營養支持方案,患者使用腸外營養第2天、頸內靜脈置管術後3 h輸註其他靜脈液體後突髮劇烈右側胸痛,不能排除導管栓塞或疾病本身導緻的肺栓塞、心肌梗死,立即對腸外營養做齣調整:暫停使用脂肪乳。經過13 d的腸外營養支持,患者病情明顯好轉併恢複經口攝入。
1례30세남성환자,인“복사반월、해점액농혈편일주”입원,진단위궤양성결장염(급성,초발형,중도,전결장,활동기)。입원제7천환자해선혈편5차,량약800 mL,반유핍력、심황、랭한,BP 86/50 mm Hg,P 100차·min-1,여금식、잠정장내영양급대증처리。림상약사협조의생의정장외영양지지방안,환자사용장외영양제2천、경내정맥치관술후3 h수주기타정맥액체후돌발극렬우측흉통,불능배제도관전새혹질병본신도치적폐전새、심기경사,립즉대장외영양주출조정:잠정사용지방유。경과13 d적장외영양지지,환자병정명현호전병회복경구섭입。
A 30-year-old male patient was admitted to the hospital with the pathogeny of two weeks' diarrhea and one week's purulent blood and mucoid stool, and diagnosed with ulcerative colitis (acute, early onset, severe, colon activity). The 7th day after hospitalization, the patient excreted blood stool for 5 times with a total volumn of 800 mL, accompanied with fatigue, palpitation, cold sweat, blood pressure 86/50 mm Hg, a pulse of 100 beats per minute. The patient was treated with the therapy of fasting and suspended enteral nutrition (EN). Clinical pharmacists assisted with physicians to make the scheme of parenteral nutrition (PN) support. Two days after the sustained usage of PN, and 3 hours after jugular vein catheterization, the patient developed a sudden severe pain of right chest when he received the infusion of venous fluids. We could not exclude the possibility of transcatheter embolization, pulmonary embolism associated with the disease or myocardial infarction, so clinical pharmacists suspended the usage of fat emulsion. After 13 days of PN support, condition of the patient signiifcantly improved, then the patient was transferred to oral intake.