临床药师参与脊柱术后感染药物治疗的实践与体会  

Pharmaceutical care on a patient with infection after spinal operation

作　　者：郭虎[1] 黄亮 周继斌[3] 杜彪[1] 方伟[1] 孙秋艳[1] GUO Hu;HUANG Liang;ZHOU Ji-bin;DU Biao;FANG Wei;SUN Qiu-yan(Department of Pharmacy,Chongqing Three Gorges Central Hospital,Chongqing 404100,China;Department of Cardiovascular Medicine,Chongqing Three Gorges Central Hospital,Chongqing 404100,China;Department of Orthopedics,Chongqing Three Gorges Central Hospital,Chongqing 404100,China)

机构地区：[1]重庆三峡中心医院药学部,重庆404100 [2]重庆三峡中心医院心血管内科,重庆404100 [3]重庆三峡中心医院骨科,重庆404100

出　　处：《中国药物应用与监测》2020年第1期32-33,55,共3页Chinese Journal of Drug Application and Monitoring

基　　金：重庆市万州区科技计划项目（wzstc-2017002）

摘　　要：1例67岁女性患者,因"腰部疼痛2周"入院,临床诊断:退变性腰椎病;腰椎间盘突出,行脊柱椎间融合器植入植骨融合内固定术+腰椎间盘切除术+脊柱截骨术,术后出现深部感染,先后给予克林霉素,莫西沙星,去甲万古霉素,疗效不佳,临床药师建议换用头孢唑林联合利福平治疗,医师予以采纳,患者感染症状很快得到了控制并出院口服药物治疗,随访1年后患者手术部位未再出现感染症状。A 67-year-old female patient was admitted to the hospital mainly because of pain in the lower back for 2 weeks.The patient was diagnosed as degenerative lumbar disease and lumbar disc herniation.Spinal interbody fusion with bone grafting and internal fixation,lumbar discectomy,spinal osteotomy were performed after admission.The patient developed deep infection after operation.Clindamycin,moxifloxacin,norvancomycin were successively given to her,but showed poor effect.Clinical pharmacist suggested that cefazolin combined with rifampicin should be used for treatment.The infection was soon controlled and the patient was discharged with oral drugs.One year of follow-up showed that the patient did not develop infection any more at the surgical site.

关 键 词：脊柱术后感染 头孢唑林 利福平 药学监护 

分 类 号：R969.4[医药卫生—药理学] R978.1[医药卫生—药学]