1例罕见的腰大肌脓肿合并新冠肺炎伴多部位软组织播散性脓肿患者的病例分析  

Case analysis of a rare case of psoas abscess complicated with COVID-19 and multiple soft tissue injuries

作　　者：程研 虞美玲 何娟[3] 陈影[2] 王义辉[2] CHENG Yan;YU Meiling;HE Juan;CHEN Ying;WANG Yihui(Department of Pharmacy,Zaozhuang Central Hospital affiliated to Shandong Guoxin Yiyang Group,Zaozhuang 277000,China;Department of Emergency,Ruijin Hospital affiliated to School of Medicine,Shanghai Jiao Tong University,Shanghai 200025,China;Department of Pharmacy,Ruijin Hospital affiliated to School of Medicine,Shanghai Jiao Tong University,Shanghai 200025,China)

机构地区：[1]山东国欣颐养集团枣庄中心医院药剂科,枣庄277000 [2]上海交通大学医学院附属瑞金医院急诊科,上海200025 [3]上海交通大学医学院附属瑞金医院药剂科,上海200025

出　　处：《上海医药》2024年第11期107-111,共5页Shanghai Medical & Pharmaceutical Journal

基　　金：国家自然科学基金面上项目(82270087);上海申康医院发展中心临床科技创新项目(SHD22021304)。

摘　　要：目的:探讨1例罕见的腰大肌脓肿合并新冠伴多部位软组织播散性脓肿患者的药物治疗过程,为临床药师提供参考。方法:通过鉴别感染与非感染,明确脓肿的病原学,评估感染严重程度,选择初始抗感染药物和给药方案;当感染控制不佳、出现新的培养结果和影像学变化时,根据抗生素的PK/PD特点优化和调整抗感染药物,并进行药学监护。结果:临床药师在治疗期间及时提出优化和调整抗生素给药方案,医师采纳后患者病情得到改善。结论:临床药师在多学科诊疗团队中的重要价值体现在协助医师优化给药方案、调整治疗药物以及全程监护药物疗效和不良反应方面。Objective:To explore the drug treatment process of a rare case of psoas abscess combined with COVID-19 and disseminated multiple soft tissue abscesses,so as to provide reference for clinical pharmacists.Methods:By differentiating between infection and non-infection,the pathogenesis of the abscess was determined,the severity of the infection was evaluated,and the initial anti-infective drugs and dosing regimen were selected.When infection control was poor and new culture results and imaging changes occurred,the anti-infective drugs were optimized and adjusted based on the pharmacokinetic and pharmacodynamic characteristics of antibiotics and pharmaceutical monitoring was performed.Results:During the treatment period,the clinical pharmacist proposed to optimize and adjust the antibiotic administration regimen in time and the patient’s condition was improved after the physician adopted it.Conclusion:The important value of clinical pharmacists in multidisciplinary diagnosis and treatment teams is reflected in assisting physicians in optimizing administration plans,adjusting therapeutic drugs,and monitoring the efficacy and adverse reactions of drugs throughout the process.

关 键 词：腰大肌脓肿 感染与非感染 PK/PD优化方案 

分 类 号：R512.99[医药卫生—内科学] R515.9[医药卫生—临床医学]