临床药师参与1例复杂性腹腔内感染并急性肾损伤患者的治疗实践  

Clinical practice of pharmacists through participating in the treatment of a patient with complicated intra-abdominal infections and acute kidney injury

作　　者：夏小凤[1] 艾凌艳[1] 谢彦兵[1] XIA Xiao-feng;AI Ling-yan;XIE Yan-bing(Department of Pharmacy, No.184 Hospital of PLA, Yingtan 335000, China)

机构地区：[1]解放军第184医院药械科,江西鹰潭335000

出　　处：《中国药物应用与监测》2017年第4期214-217,共4页Chinese Journal of Drug Application and Monitoring

摘　　要：1例74岁女性患者,因持续腹痛2 d入院就诊。入院诊断为上消化道穿孔并急性弥漫性腹膜炎,入院后行"剖腹探查+十二指肠球部溃疡穿孔修补术",先给予头孢噻肟钠舒巴坦钠联合奥硝唑抗感染治疗4 d,后采纳临床药师建议更换为莫西沙星联合奥硝唑抗感染治疗11 d,并予抑酸、保肝、抗心律失常、营养支持、维持体液平衡等治疗。临床药师主要对抗菌药物的选择、营养支持方案的分析以及不良反应监测等方面进行了药学监护和干预。治疗21 d后,患者病情好转出院。One74-year-old female patient was hospitalized for persistent abdominal pain for2days.She was diagnosed withupper gastrointestinal tract perforation and acute diffuse peritonitis.After admission,the patient received laparotomy and duodenalulcer perforation repair.Cefotaxime sodium and sulbactam sodium combined with ornidazole were treated for anti-infection for4days.Later,the doctor took the advice of clinical pharmacist,switching to moxifloxacin combined with ornidazole for anti-infectionfor11days.Acid suppression,protecting liver,anti-arrhythmic,nutritional support,maintaining fluid balance and other treatmentswere also applied.The clinical pharmacist provided pharmaceutical care including the selection of antibacterials,analysis of thenutritional support scheme and adverse reaction monitoring,etc.The patient was getting better and discharged from hospital21days later.

关 键 词：复杂性腹腔内感染 临床药师 莫西沙星 头孢噻肟钠舒巴坦钠 

分 类 号：R656[医药卫生—外科学]