临床药师参与1例卒中伴房颤患者的抗凝治疗分析  

Analysis of anticoagulant therapy of clinical pharmacist in one patient with stroke and atrial fibrillation

作　　者：孟利娜[1] 刘洋[1] 

机构地区：[1]鄂尔多斯市中心医院药剂科,内蒙古鄂尔多斯017000

出　　处：《中南药学》2017年第8期1154-1156,共3页Central South Pharmacy

摘　　要：目的探讨临床药师参与卒中伴房颤患者抗凝治疗的方法和药学服务。方法临床药师参与1例卒中伴房颤患者的抗凝诊疗过程,针对抗凝治疗指征及目标值、华法林桥接低分子肝素的目的、华法林的药物相互作用、INR异常升高的处理以及华法林的用药教育等方面进行综合分析。结果临床药师在抗凝治疗中,为患者建立了抗凝治疗信息档案,同时发现抗凝治疗问题,及时向医师提供合理化的治疗建议。结论临床药师参与抗凝治疗管理,促进患者安全、合理、有效地使用药物。Objective To detect the change of plasma brain derived neurotrophic factor（BDNF） concentrations after the application of dexmedetomidine peri-operatively. Methods Totally 60 ASA I-II patients undergoing laparoscopic cholecystectomy were randomly divided into 2 groups： a Sham group and a Dex group. The plasma BDNF levels were determined by ELISA at 5 time points： T1（before entering the surgery room/baseline）, T2（15 min after induction）, T3（end of surgery）, T4（10 min after extubation）, and T5（24 h after the surgery）. The total amount of anesthetics and visual analogue scale（VAS） scores for each patient were also recorded. Results（1） Amount of anethetics： Compared with the Sham group, there was a significant decrease in the dose of anesthetics in the Dex group（P 0.05）;（2） VAS scores： VAS scores were close between the 2 groups at T4 and T5;（3） BDNF levels： there was no difference in the baseline of BDNF levels between the 2 groups at T1, T4（P 0.05）. However, significant difference was found at T2, T3 and T5. Conclusion Dex can attenuate the decrease of plasma BDNF levels induced by anesthetics, which may last 24 h after the surgery.

关 键 词：临床药师 卒中伴房颤 抗凝治疗 药学服务 

分 类 号：R654.2[医药卫生—外科学]