1例重型颅脑损伤术后感染患者的药学监护  

Pharmaceutical Care for One Case of Severe Brain Injury with Infection after Decompressive Craniotomy

作　　者：贾立华[1] 李勇[2] 

机构地区：[1]解放军307医院药学部,北京100071 [2]北京军区总医院药理科

出　　处：《中国药师》2015年第12期2126-2129,共4页China Pharmacist

摘　　要：目的:探讨临床药师参与临床抗感染治疗用药过程的模式。方法:对1例重型颅脑损伤双侧去骨瓣减压术后肺部和颅内感染患者的抗细菌和抗真菌治疗提出合理化用药建议,并进行用药监护。结果:临床药师先后建议采用氟康唑治疗方案和两性霉素B治疗方案分别治疗32 d和28 d,治疗期间分别针对分流管相关表皮葡萄球菌和施氏假单胞菌感染提出治疗建议对伏立康唑和两性霉素B不良反应预警和监护,针对药敏结果变化及时调整抗感染治疗,治疗效果明显。结论:临床药师参与药物治疗过程可优化治疗方案,有利于医药团队协作。Objective： To explore the participation mode of clinical pharmacists in anti-infective therapy. Methods： Clinical phar- macists provided rational medication suggestions for anti-bacterial and antifungal therapy, and carried out pharmaceutical care for one patient with lung and intracranial infection after decompressive craniotomy for severe brain injury. Results： According to the sugges- tions of clinical pharmacists, fluconazole therapeutic regimen and amphotericin B therapeutic regimen was applied in turn respectively with the treatment course of 32d and 28d. During the treatment, the pharmacists also provided therapy advice on the infection induced by Staphylococcus epidermidis and Pseudomonas stutzeri, ADR warning and monitoring of fluconazole and amphotericin B, and adjust- ment of anti-infective therapy according to the results of antimicrobial susceptibility testing. The therapeutic effect was significant. Conclusion： The participation of clinical pharmacists in drug treatment can optimize medical therapy, which contributes to the cooperation between doctors and pharmacists.

关 键 词：临床药师 重型颅脑损伤 颅内感染 药学监护 

分 类 号：R651.15[医药卫生—外科学]