1例瓣膜置换联合冠状动脉旁路移植术后患者抗栓治疗的药学监护  

Pharmaceutical Care of Antithrombotic Therapy of One Case of Patients Undergoing Coronary Artery Bypass Grafting Combined with Value Replacement after Operation

作　　者：向竹枝[1,2] 钱皎[1] 

机构地区：[1]第二军医大学附属长海医院药学部,上海200433 [2]长江航运总医院药剂科

出　　处：《药物流行病学杂志》2016年第6期377-380,共4页Chinese Journal of Pharmacoepidemiology

基　　金：国家科技支撑计划子课题(编号:2013BA206B04Y023013);第二军医大学长海医院"1255"学科特色提升项目(编号:CH12552400)

摘　　要：目的:探讨临床药师对冠状动脉旁路移植术(CABG)合并瓣膜置换的患者实施药学监护的方法和思路。方法:临床药师对1例CABG合并瓣膜置换术后的患者进行查房密切观察和药学教育,参与个体化抗栓方案的制定,规范患者用药问题,监测疗效与药品不良反应,给患者提供用药教育。结果:通过药师治疗全过程中细致的药学监护和医嘱干预,确定符合患者特点的抗栓方案,避免不良反应的发生,提高患者治疗的依从性和药物治疗效果。结论:临床药师积极开展药学监护,协同临床医师优化给药方案,有利于患者用药的安全性和有效性。Objective：To discuss the approaches and significance of clinical pharmacy guardianship of patients undergoing coronary artery bypass grafting combined with value replacement after operation. Methods：Clinical pharmacist provided close pharmaceutical rounds and pharmaceutical education for one case of patients undergoing coronary artery by- pass grafting combined with value replacement after operation, including actively participating in the development of the regimen of anticoagulation and antiplatelet therapy, standardizing the problems in the medication , monitoring adverse drug reaetions and providing medication education. Results：The meticulous pharmaeeutieal eare and medication intervention by pharmacist in the whole process avoid the occurrence of adverse events and improve the effects of drug treatment, and the antithrombotie therapy was determined according to the characteristics of the patient. Conclusion：The clinical pharmacist actively carries out pharmaceutical care, collaborates clinicians to optimize dosing regimens , which are conducive to patients with safe and effective medication.

关 键 词：冠状动脉旁路移植术 瓣膜置换 临床药师 药学监护 

分 类 号：R97[医药卫生—药品]