对1例老年贫血伴慢性肾功能不全患者的药学监护  

Pharmaceutical care of an elderly patients with anemia and chronic renal insufficiency

作　　者：郑策[1] 薛嫱[2] 甄健存[1] 

机构地区：[1]北京积水潭医院药剂科,北京100035 [2]北京积水潭医院干部保健科,北京100035

出　　处：《中国药物应用与监测》2011年第1期30-32,共3页Chinese Journal of Drug Application and Monitoring

摘　　要：1例80岁女性患者,因纳差、全身乏力入院。既往有结肠癌、慢性肾功能不全病史,入院诊断为贫血、慢性肾功能不全。采用口服维生素B12和叶酸、皮下注射促红细胞生成素(EPO)、输血以及静脉补铁等治疗措施。因患者不能耐受口服铁剂,建议静脉给予右旋糖酐铁,结合患者病情计算补铁量,并对输注过程中的不良反应进行监测。为迅速改善和减轻贫血症状,给予一次性输注400mL红细胞悬液,大剂量输血使患者肾功能恶化,建议调整剂量为200mL。出院后回访患者用药情况,因患者隔日服用琥珀酸亚铁片产生轻微胃肠道刺激症状,药师建议换用多糖铁复合物,之后症状缓解。An 80-year-old woman with colon cancer and chronic renal insufficiency was hospitalized for anorexia and fatigue.The patient was diagnosed as anemia and treated with oral vitamin B12 and folic acid,subcutaneous EPO,blood transfusions and intravenous iron.Clinical pharmacist took pharmaceutical care by subcutaneous administration of iron dextran,calculating iron amount according to the patient condition,and monitoring the adverse reaction during the infusing process.Infusion with large dose caused aggravation of renal function and the dose of blood infusion was adjusted to 200 mL.The patient feel uncomfortable on stomach for the administration of iron when he discharged from hospital.The symptom was relieved after clinical pharmacist adjusted polysaccharide-iron complex instead.

关 键 词：慢性肾功能不全 贫血 老年 药学监护 

分 类 号：R692.5[医药卫生—泌尿科学] R556[医药卫生—外科学]