结直肠癌住院患者分阶段药学监护模式的构建与实践  

Establishment and practice of staged pharmaceutical care model for inpatients with colorectal cancer

作　　者：薛静[1] 黄小艳 高旻[1] 黎小妍[1] XUE Jing;HUANG Xiaoyan;GAO Min;LI Xiaoyan(Department of Clinical Pharmacology,the Sixth Affiliated Hospital of Sun Yat-Sen University,Guangzhou,Guangdong,510655,China)

机构地区：[1]中山大学附属第六医院药学部,广州510655

出　　处：《肿瘤药学》2022年第1期117-121,共5页Anti-Tumor Pharmacy

摘　　要：目的探讨临床药师参与结直肠癌(CRC)住院患者分阶段药学监护模式。方法制定住院CRC患者分阶段的药学监护模式及监护内容,依据该监护模式对1例使用FOLFIRI方案(伊立替康+左亚叶酸钙+氟尿嘧啶)发生3度迟发性腹泻及2度口腔溃疡的CRC患者进行分阶段药学监护。具体内容包括化疗前的药学监护,如肝肾功能及血常规的评估、既往不良反应程度的评估、化疗药物剂量调整的评估;化疗中的药学监护,如化疗药物预处理的合理性、化疗药物致吐级别的评估与监护;化疗后的药学监护,如不良反应监测、出院带药建议及患者用药教育。结果通过制定并实施CRC患者分阶段药学监护模式,患者得到了个体化的治疗方案,药品不良反应得到了及时发现与干预。结论通过制定住院CRC患者分阶段药学监护模式,临床药师可以对该类患者进行有效的用药监护;本模式可为临床药师参与临床药物治疗工作模式提供一定的参考。Objective To explore the clinical pharmacist’s participation in the staged pharmaceutical care model for inpatients with colorectal cancer (CRC).Methods Develop the staged pharmaceutical care model and contents for inpatients with CRC. According to the this model, clinical pharmacist practiced pharmacological care for a patient who got FOLFIRI (irinotecan+calcium levofolinate+fluorouracil) chemotherapy and developed grade 3 delayed-onset diarrhea and grade 2 oral ulcers. Specific contents included pharmacological care such as examination of liver and kidney function and blood routine, evaluation of degrees of previous adverse reactions, assessment of chemotherapy drug dose adjustment before chemotherapy;rationality of pretreatment of chemotherapy drugs, evaluation of vomiting level of chemotherapy drugs and its monitoring during chemotherapy;adverse reaction monitoring, discharge drug advice, and medication education after chemotherapy.Results With the implementation of the staged pharmaceutical care model, the patient received individualized treatment plans, and the adverse drug reactions were discovered and intervened in time.Conclusion By formulating a staged pharmaceutical care model, clinical pharmacists can take effective pharmaceutical care for inpatients with colorectal cancer. This model provides a reference for clinical pharmacists to participate in the clinical drug treatment work.

关 键 词：结直肠癌 临床药师 药学监护模式 

分 类 号：R735.3[医药卫生—肿瘤] R95[医药卫生—临床医学]