临床药师对肠穿孔致复杂性腹腔感染新生儿抗感染治疗的个体化药学监护实践  

Individualized pharmaceutical monitoring practice of clinical pharmacists in treatment of complex abdominal infections caused by intestinal perforation in newborns with anti-infection therapy

作　　者：王延鹏 王贲士 秦一卓 马燕 刘畅 Wang Yan-peng;Wang Bi-shi;Qin Yi-zhuo;Ma Yan;Liu Chang(Pharmacy Department of Shandong Provincial Third Hospital,Jinan 250000,China;Gastrointestinal Surgery Department of Shandong Cancer Hospital,Jinan 250000,China;Pediatrics Department of Shandong Provincial Third Hospital,Jinan 250000,China;Clinical Medicine Department of Qingdao Women and Children’s Hospital,Qingdao 266000,China)

机构地区：[1]山东省立第三医院药学部,济南250000 [2]山东省肿瘤医院胃肠外科,济南250000 [3]山东省立第三医院儿科,济南250000 [4]青岛妇女儿童医院临床药学科,青岛266000

出　　处：《中国药物应用与监测》2024年第2期196-198,共3页Chinese Journal of Drug Application and Monitoring

基　　金：山东省医学会临床科研专项资金项目(YXH2021ZX019)。

摘　　要：肠穿孔致复杂性腹腔感染新生儿抗感染治疗个体化药学监护案例。1例足月顺产生后2 d女婴因“生后呼吸困难、腹胀2天”入院,患儿腹腔积液,病情危重,进展迅速;入院第2天行“肠黏连松解术+回肠造瘘术+回肠部分切除术”,术中诊断回肠穿孔;腹水培养提示屎肠球菌感染。临床药师对该患者进行全程药学监护,在抗感染经验用药及目标治疗、万古霉素血药浓度监测和剂量调整等治疗方案的制定与调整方面,发挥了积极作用,患儿感染得到有效控制,痊愈出院。A female infant was admitted to the hospital 2 days after the onset of full-term pregnancy due to“difficult breathing and bloating for 2 days after birth”.The patient had abdominal fluid accumulation and the condition was critical,progressing rapidly;On the second day of admission,the patient underwent“intestinal adhesiolysis surgery+ileostomy+partial resection of the ileum”,and was diagnosed with ileal perforation during the surgery.Ascites culture suggested infection with Enterococcus faecalis.The clinical pharmacist provided full pharmaceutical monitoring for the patient,and played a positive role in the formulation and adjustment of treatment plans such as anti-infection experience medication and target treatment,monitoring of vancomycin blood concentration,and dosage adjustment.The patient’s infection was effectively controlled.She recovered well and was discharged.

关 键 词：复杂性腹腔感染 抗感染 血药浓度监测 药学监护 新生儿 

分 类 号：R95[医药卫生—药学]