| Objective: To investigate the parenteral nutrition prescription of patients with clinical colorectal cancer in our hospital;to investigate the effect of monovalent electrolyte concentration on the stability of parenteral nutrition solution;to simulate the p H value of parenteral nutrition solution and construct a statistical model.Predicting its stability,providing reference for standardizing clinical nutritional support and treatment.Method:Part one: Analysis of total parenteral nutrition prescription of patients with colorectal cancerBy retrospective analysis,the parenteral nutrition prescriptions of patients with colorectal cancer were collected from April 2016 to April 2017.The general data of patients who had used parenteral nutrition,the types of parenteral nutrition products,as well as the ratio of energy to nitrogen(E/N),glucose /lipid(G/L)ratio,and the composition of substances are analyzed and evaluated.Part two: Effect of nonovalent cation ions on the stability of parenteral nutrition solutionSeven formulations were designed with 7 different monovalent cation ion concentrations containing the same components.According to sterile operation procedure,and at room temperature,their microbial limit,appearance,p H value,and emulsion particle size were investigated at 0,8,and 24 h.Part three : Multivariate Regression Prediction Model for p H of parenteral nutrition solutionA total of 99 clinically used parenteral nutrition solutions were randomly selected.A multivariate linear regression method was used to construct a statistical model to predict the stability of parenteral nutrition solution.The equations were tested by residual and relative error test.Result:Part one: Analysis of total parenteral nutrition prescription of patients with colorectal cancerParenteral nutrition prescriptions were collected from 766 patients and existed higher rationality.The E/N(100~200:1)accounted for 35.9% and the G/L(1~2:1)30.3%.Therefore,the rational application of parenteral nutrition should be a priority in clinical settings.The intervention of irrational prescription of parenteral nutrition needs the participation of clinical pharmacists to ensure that TPN prescriptions are rational,safe and effective.Part two: Effect of potassium ions on the stability of parenteral nutrition solution There was no observable alteration in color,phase separation,precipitate,and flocculation in any admixture at any of the observation time points;The mean p H values for all groups were between(5.58±0.01)to(5.95±0.02)within 24 hours;The mean diameters of lipid globules for all groups were between(280.2±5.3)nm to(316.0±13.8)nm;The mean polydispersity for all groups were between(0.020±0.003)to(0.099±0.044);with the concentration of nonovalent cations increased,there was a statistical difference in p H,average particle size,and polydispersity index PDI and a significant decrease in the cumulative ratio of 5 μm particle size.Part three : Multivariate Regression Prediction Model for p H of parenteral nutrition solutionBy analyzing the concentration of each substance in the parenteral nutrient solution,glucose,potassium ion,chloride ion,calcium ion,and magnesium ion concentration have an effect on the p H value,and the p H value increases with the increase of the potassium ion concentration and decreases with other substances’ concentration increase;the multivariate linear regression prediction model of p H has a prediction error of less than 1.3%,and the overall accuracy is reasonable.Conclusion:Clinicians should strengthen the knowledge of parenteral nutrition,and formulate a reasonable individualized drug delivery plan according to the nutritional status of patients;clinical pharmacists should rely on the static matching center to strengthen the TPN prescription review,and focus on screening the stability of electrolytes on TPN stability.To ensure the compatibility and application safety of TPN. |
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