Objective:To explore the working pattern and pharmaceutical monitoring emphasis of clinical pharmacists in gastrointestinal surgery department.Methods:Taking the nutritional support treatment in patients with anastomotic stenosis and risk of refeeding syndrome(RFS)after radical gastrectomy as an example,the cut-in points and emphasis of pharmaceutical monitoring for clinical pharmacists working in the gastrointestinal surgery department were elaborated.Results:Through screening and evaluation of nutritional risks,clinical pharmacists identified that the patient was severely malnourished and had risk of RFS,and suggested to correct electrolyte disturbances,with concurrent treatment with vitamin B1 to prevent Wernicke encephalopathy,before nutritional support.Then,the pharmacists assisted physicians in formulating individualized nutritional support scheme,according to the principle of"gradual change from small amounts to large amounts and low speed to high speed",and carried out pharmaceutical monitoring throughout the process.The patient responded to the 16 days of treatment with oral intake of some food and improved nutritional status,and was discharged with elective chemotherapy.Conclusion:For patients with severe malnutrition,the nutritional support should be initiated with attention to RFS.Individualized nutritional support and pharmaceutical monitoring can give full play to the professional characteristics of clinical pharmacists,help patients get more benefits from nutritional support,and play an active role in promoting the rational development of clinical nutritional support.
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