Page 280 - 北京京煤集团总医院第十一届·2023学术年会论文集

北京京煤集团总医院 第十一届·2023 学术年会论文集

脂肪乳注射剂导致脂肪超载综合征致Ⅲ度血小板减少 1 例

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邢鹏 ，王丽丽 ，刘建平 ，陈莲珍
（1 北京京煤集团总医院药剂科，北京 102300；2 国家癌症中心/国家肿瘤临床医学中心/
中国医学科学院北京协和医学院肿瘤医院药剂科, 北京 100021）
【摘要】本文报道 1 例 44 岁男性患者因肠梗阻行肠粘连松解术，术后给予肠外营养，脂肪

乳注射液的给药方式包括：加入工业化营养三腔袋和单瓶输住；其中脂肪乳摄入量 2.41 g/kg•

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d 持续 8 天、3.9g/kg•d 持续 8 天。用药 21d 后出现乳糜血，血清甘油三酯高于检测上限。
临床药师考虑为长期大量使用脂肪乳注射剂所致，遂停药。出院 5 天后，该患者再次出现发

热伴血小板降低、凝血功能异常再次入院。入院 ICU 1 天后患者家属要求转院治疗，转归不

详。患者最终病情进展不排除为脂肪超载综合征，脂肪乳对免疫抑制及炎症激活的影响。本

案例提示应加强对医师、药师和护士的肠外营养相关知识的培训，具备规范化开具、审核和

使用肠外营养的能力。

【关键词】脂肪乳注射剂，脂肪超载综合征，肠外营养

A case of lipid overload syndrome and grade Ⅲ thrombocytopenia caused by fat emulsion

injection

Xingpeng , Wanglili , Liujianping , Chen Lianzhen 2*
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1 Department of Pharmacy Beijing Jingmei Group General Hospital,Beijing 102300,China

2 Department of Pharmacy,National Cancer Center/National Clinical Research Center for Cancer/
Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College,

Beijing 100021, China

[Abstract] A 44-year-old male patient underwent intestinal adhesion lysis due to intestinal

obstruction and was given parenteral nutrition(PN) postoperatively. The administration methods of

fat emulsion injection included adding industrial nutrition three chamber bags and infusing a single

bottle. The intake of fat emulsion was 2.41g/kg • d for 8 days, and 3.9g/kg • d for 8 days. After
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21 days of medication, the patient developed chylemia with high level of triglyceride exceeding the

upper limit, which was considered by clinical pharmacist as the adverse reaction of long-term and

extensive use of fat emulsion then immediately discontinued. The patient was readmitted 5 days

after discharge due to fever, thrombocytopenia and coagulation abnormalities. One day after

readmission ICU, the patient was transferred to another hospital and whose outcome was unknown.

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