临床药师参与乙型肝炎肝硬化腹水合并脓毒性休克的抗菌药物治疗实践
|
摘要
目的通过参与一例脓毒性休克患者治疗的病例,引起临床对于肝硬化腹水感染患者治疗的警惕,评价临床药师参与临床治疗的价值,为临床治疗提供参考。方法临床药师通过对1例乙型肝炎肝硬化腹水合并脓毒性休克患者的高危因素及用药进行分析,提供药物治疗建议,并对患者进行药学监护。结果医师采纳临床药师建议进行药物治疗后,该患者脓毒性休克好转出院。结论临床药师参与临床查房为患者制定个体化药物治疗方案,体现了临床药师的专业水平,保障了患者合理用药。
Objective Pharmacists participated in the treatment of one patient with septic shock caused by hepatitis B cirrhosis ascites, then to evaluate the role of clinical pharmacists and provide reference for clinical treatment. Methods Clinical pharmacists provided pharmacological advice on the treatment of a patient with Hepatitis B cirrhosis and ascites combined with septic shock,and analyzed the high-risk factors of the patient,and performed medical supervision on the patient. Results After the doctor adopted the clinical pharmacist's recommendation for drug treatment,the patient's septic shock was improved and discharged. Conclusion Clinical pharmacies participate in the clinical rounds to designate individualized drug treatment plans for patients,which reflects the clinical pharmacist's professional level and ensures the rational and safe use of drugs.
Objective Pharmacists participated in the treatment of one patient with septic shock caused by hepatitis B cirrhosis ascites, then to evaluate the role of clinical pharmacists and provide reference for clinical treatment. Methods Clinical pharmacists provided pharmacological advice on the treatment of a patient with Hepatitis B cirrhosis and ascites combined with septic shock,and analyzed the high-risk factors of the patient,and performed medical supervision on the patient. Results After the doctor adopted the clinical pharmacist's recommendation for drug treatment,the patient's septic shock was improved and discharged. Conclusion Clinical pharmacies participate in the clinical rounds to designate individualized drug treatment plans for patients,which reflects the clinical pharmacist's professional level and ensures the rational and safe use of drugs.
引文
[1]中华医学会肝病学分会.肝硬化腹水及相关并发症的诊疗指南.临床肝胆病杂志,2017,33(10):1847-1863.
[2]董磊,张辉,段美丽,等.脓毒性休克的临床流行病学调查:1087例全国多中心临床研究.中国临床医学,2010,17(3):436-438.
[3]江宇,刘刚,龚玲,等.慢性肝病、肝硬化并发感染性休克临床分析.中华医院感染学杂志,2007,17(11):1365-1367.
[4] RS Lo,AS Austin.Is There a Role for Probiotics in Liver Disease?The Scientific World Journal, 2014:768-874.
[5]许吉生,王建中,段建华,等.肝硬化患者感染性休克临床特征及预后.中华医院感染学杂志,2015,25(5):1000-1002.
[6]高戈,冯喆,常志刚,等. 2012国际严重脓毒症及脓毒性休克诊疗指南.中华危重病急救医学,2013,25(8):501-505.
[7]杨丽霞.肝硬化合并自发性细菌性腹膜炎早期诊断的研究进展.江西医药,2017,52(10):1098-1101.
[8]周峰,晏玉奎,许岚,等.急腹症感染性休克患者病原菌分布及耐药性研究.中华医院感染学杂,2017,27(5):1082-1084,1088.
[9] Davis BC, Bajaj JS. The Human Gut Microbiome in Liver Diseases.Seminars in Liver Disease, 2017, 37(2):128-140.
[10]陈黎明,王陆军,曾珍,等.失代偿性肝硬化患者感染性休克的临床特征分析.中华医院感染学杂志,2003,13(10):930-931.
[11]李丽,汪莉萍,王世轶,等.数据挖掘工具在大肠埃希菌头孢呋辛耐药趋势分析中的应用.中国抗生素杂志,2014,39(7):549-552,后插6页.
[12]江利冰,李瑞杰,张斌,等. 2016年脓毒症与脓毒性休克处理国际指南.中华急诊医学杂志,2017,26(3):263-266.
[13]产超广谱β-内酰胺酶细菌感染防治专家委员会.产超广谱β-内酰胺酶细菌感染防治专家共识.中华实验课临床感染病杂志(电子版),2010,4(2):207-214.
[2]董磊,张辉,段美丽,等.脓毒性休克的临床流行病学调查:1087例全国多中心临床研究.中国临床医学,2010,17(3):436-438.
[3]江宇,刘刚,龚玲,等.慢性肝病、肝硬化并发感染性休克临床分析.中华医院感染学杂志,2007,17(11):1365-1367.
[4] RS Lo,AS Austin.Is There a Role for Probiotics in Liver Disease?The Scientific World Journal, 2014:768-874.
[5]许吉生,王建中,段建华,等.肝硬化患者感染性休克临床特征及预后.中华医院感染学杂志,2015,25(5):1000-1002.
[6]高戈,冯喆,常志刚,等. 2012国际严重脓毒症及脓毒性休克诊疗指南.中华危重病急救医学,2013,25(8):501-505.
[7]杨丽霞.肝硬化合并自发性细菌性腹膜炎早期诊断的研究进展.江西医药,2017,52(10):1098-1101.
[8]周峰,晏玉奎,许岚,等.急腹症感染性休克患者病原菌分布及耐药性研究.中华医院感染学杂,2017,27(5):1082-1084,1088.
[9] Davis BC, Bajaj JS. The Human Gut Microbiome in Liver Diseases.Seminars in Liver Disease, 2017, 37(2):128-140.
[10]陈黎明,王陆军,曾珍,等.失代偿性肝硬化患者感染性休克的临床特征分析.中华医院感染学杂志,2003,13(10):930-931.
[11]李丽,汪莉萍,王世轶,等.数据挖掘工具在大肠埃希菌头孢呋辛耐药趋势分析中的应用.中国抗生素杂志,2014,39(7):549-552,后插6页.
[12]江利冰,李瑞杰,张斌,等. 2016年脓毒症与脓毒性休克处理国际指南.中华急诊医学杂志,2017,26(3):263-266.
[13]产超广谱β-内酰胺酶细菌感染防治专家委员会.产超广谱β-内酰胺酶细菌感染防治专家共识.中华实验课临床感染病杂志(电子版),2010,4(2):207-214.