中国临床药学杂志

目的 探讨临床药师主导的多学科营养管理模式在围手术期肝棘球蚴病患者中的应用效果。方法 收集2023年1至12月收治的肝棘球蚴病患者50例作为观察组，2022年1至12月收治的肝棘球蚴病患者50例作为对照组。对照组接受常规围手术期营养支持治疗，观察组采用临床药师主导的多学科营养管理模式干预，比较2组患者营养状况、肝功能、术后并发症及临床结局。结果 术前1 d，观察组前白蛋白、转铁蛋白、视黄醇结合蛋白水平显著高于对照组（P<0.05）；术后第7天，观察组总蛋白、白蛋白、前白蛋白、转铁蛋白、视黄醇结合蛋白水平高于对照组（P<0.05），观察组谷草转氨酶、谷丙转氨酶水平低于对照组（P<0.05），胆碱酯酶水平高于对照组（P<0.05），术后胸腹腔积液、肝功能不全及低蛋白血症的发生率低于对照组（P<0.05），术后使用肠外营养时间、术后开启肠内营养的时间、恢复通气时间及住院时间少于对照组（P<0.05），住院费用低于对照组（P<0.05）。结论临床药师主导的多学科营养管理模式能明显改善肝棘球蚴病患者围手术期的营养状态及肝功能，促进患者术后胃肠道功能的恢复，降低术后并发症的发生率，改善患者的临床结局。

AIM To investigate the effect of a multidisciplinary nutrition management model led by clinicalpharmacists in patients with hepatic echinococcosis in the perioperative period. METHODS The clinical data of 50 patientswith hepatic echinococcosis admitted to the hospital from January 2022 to December 2022(control group) and 50 patientswith hepatic echinococcosis admitted from January 2023 to December 2023(observation group) were retrospectivelyanalyzed. Patients in the control group received conventional perioperative nutritional treatment mode, and patients in theobservation group adopted the multi-disciplinary nutrition management model led by clinical pharmacists. Differencesin nutritional status, liver function, postoperative complications and clinical outcomes were compared between 2 groups. RESULTS Levels of prealbumin, transferrin and retinol-binding protein in the observation group were significantly higherthan those in the control group 1 day before surgery(P < 0.05). Levels of total protein, albumin, prealbumin, transferrin andretinol-binding protein in the observation group were higher than those in the control group 7 days after surgery(P < 0.05).On the 7th day after surgery, levels of aspartate aminotransferase and alanine aminotransferase in observation group werelower than those in control group, while levels of cholinesterase were higher than those in control group(P < 0.05). Theincidence of postoperative thoracoabdominal effusion, hepatic insufficiency and hypoproteinemia in the observation groupwas lower than that in the control group(P < 0.05). Compared with the control group, the time of postoperative parenteralnutrition support, postoperative enteral nutrition, resuming ventilation and the length of hospital stay were shorter in the observation group, and the hospitalization cost was lower(P < 0.05). CONCLUSIONS The multi-disciplinary nutritionmanagement model led by clinical pharmacists could significantly improve the nutritional status and liver function ofpatients with hepatic echinococcosis during the perioperative period, promote the recovery of gastrointestinal function,reduce the occurrence of postoperative complications, and significantly improve the clinical outcome of patients.