心外科小儿地高辛的血药浓度监测及临床研究  

Monitoring and clinical study of Digoxin blood concentration in children of cardiac surgery

作　　者：陈飞[1] 陈景伟[2] 钟伟章[3] 

机构地区：[1]广东省茂名市人民医院药剂科,广东茂名525000 [2]广东省茂名市人民医院心外科,广东茂名525000 [3]广东省高州市人民医院药剂科,广东高州525200

出　　处：《中国医药科学》2012年第7期24-25,共2页China Medicine And Pharmacy

基　　金：广东省茂名市科技计划立项项目(2007198)

摘　　要：目的为临床需进行心脏修复手术的患儿安全、有效、合理使用地高辛提供参考依据。方法利用荧光偏振免疫法监测2007～2010年213例心脏外科小儿患者地高辛的血药浓度,研究其血药浓度与给药剂量、方法、患儿年龄、体重、临床疗效及中毒量的关系。结果低于治疗范围的有27例患者,均未出现中毒症状,13例心衰缓解,14例需调高剂量;在177例有效治疗浓度内有3例患者出现轻微中毒症状,占1.7%,5例需调高剂量;高于治疗范围的9例患者中有2例出现中毒症状,占22.2%;中毒的临床表现中2例为房室传导阻滞,5例均有消化道反应。结论临床药师必需与临床医师紧密配合,及时监测地高辛血药浓度,并分析监测结果和患者临床症状,确保地高辛的临床治疗安全有效。Objective To provide a reference information for children who need for heart surgery with safe,effective and rational use of Digoxin.Methods Using fluorescence polarization immune method to monitor blood drug concentration of 213 heart surgical children from 2007 to 2010.To research the relationship of its blood drug concentration,pharmaceutical volume,method,age,weight,clinical effect and the poisoning volume.Results 27 cases were lower than the treatment range with no symptoms of poisoning.13 cases heart failure relieved,and 15 cases needed adjust high dose.Among 177 cases within the effective blood concentration,3 cases had symptoms of poisoning accounting for only 1.7%,and 5 cases needed increase the dose.There were 9 cases who were beyond the effective scope,and only 2 cases had symptoms of poisoning accounting for only 22.2%.2 cases atrioventricular block,and 5 cases had digestive tract reaction.Conclusion Clinical pharmacists must work closely with clinicians,monitoring serum Digoxin concentration monitoring timely and the clinical symptoms for the results.Design an individual dose regimen to reduce the occurrence of toxic effects,ensure safe and effective clinical treatment of Digoxin and reduce the risk of surgery.

关 键 词：心脏手术 小儿 地高辛 药物监测 血清浓度 

分 类 号：R969[医药卫生—药理学] R972.1[医药卫生—药学]