1例化疗致发热性中性粒细胞减少症儿童患者的药学监护  

Pharmaceutical care on a child with febrile neutropenia caused by chemotherapy

作　　者：刘旭[1] 闫赋琴[1] 薛婧[1] 刘洋[1] 吕娟丽[1] 王楠[1] LIU Xu;YAN Fu-qin;XUE Jing;LIU Yang;LV Juan-li;WANG Nan(Department of Pharmacy,General Hospital of Chinese People＇s Armed Police Forces,Beijing 100039,China)

机构地区：[1]武警总医院药剂科,北京100039

出　　处：《中国药物应用与监测》2018年第3期154-157,共4页Chinese Journal of Drug Application and Monitoring

摘　　要：1例1岁男童患儿,因确诊神经母细胞瘤3周,拟行化疗入院。入院后患儿行第1轮化疗,化疗药物选择为:长春新碱、环磷酰胺、表阿霉素。化疗术后第5天患儿精神欠佳伴发热(38.2℃),白细胞、中性粒细胞、血红蛋白及血小板指标显著降低。诊断为"化疗术后发热性中性粒细胞减少症",给予头孢曲松钠、利巴韦林、重组人粒细胞集落刺激因子(rh GCSF)、血小板及重组人白介素-11(rh IL-11)进行抗感染,升白细胞及升血小板治疗。治疗期间,临床药师对患儿进行了化疗药物治疗前风险评估,并根据发热伴粒细胞缺乏患者治疗指南对患儿治疗过程中使用的化疗药物及抗菌药物、rh G-CSF、rh IL-11等进行全程药学监护与分析,协同医师制定合理的给药方案。最终患儿治疗过程顺利,病情平稳,予以出院。One case of 1-year-old boy diagnosed as neuroblastoma 3 weeks ago was admitted to hospital. After admission, the patient was treated with the first cycle chemotherapy including vincristine, cyclophosphamide, pharmorubicin. Five days later, he developed mental distress and fever（38.2℃） with obviously low level of WBC, neutrophils, hemoglobins and platelets. He was diagnosed as febrile neutropenia after chemotherapy and was given ceftriaxone sodium and ribavirin for anti-infection, recombinant human granulocyte colony-stimulating factor（rh G-CSF） to increase the number of WBC and neutrophils, recombinant human interleukin-11（rh IL-11） to increase the number of platelets. Clinical pharmacists carried out pharmaceutical care during the whole treatment, including risk evaluation before chemotherapy, giving rational use advices of antibiotics, rh G-CSF and rh IL-11 according to guidelines for ferile neutropenic patients. After comprehensive treatment, the patient was in stable condition and discharged.

关 键 词：发热性中性粒细胞减少症 儿童 临床药师 药学监护 

分 类 号：R969.4[医药卫生—药理学]