药师参与用药咨询门诊对左炔诺孕酮避孕失败患者妊娠选择及母婴结局的影响  

Pharmacological Intervention and Reflection on the Impact of Levonorgestrel Contraceptive Failure on Maternal and Infant Outcomes

作　　者：肖灿 刘湘 龙靓 谢希 XIAO Can;LIU Xiang;LONG Liang;XIE Xi(Xiangtan Central Hospital,Xiangtan,Hunan,China 411100)

机构地区：[1]湖南省湘潭市中心医院,湖南湘潭411100

出　　处：《中国药业》2025年第8期124-127,共4页China Pharmaceuticals

基　　金：湖南卫生健康委卫生科研课题[D202313019675]。

摘　　要：目的为进一步优化开展妊娠期患者用药咨询提供参考。方法查询某院用药咨询门诊妊娠用药咨询数据,选取2021年1月至2023年5月9例左炔诺孕酮避孕失败患者的妊娠相关用药咨询,电话随访了解患者的妊娠选择及妊娠结局,并结合文献分析。结果9例患者平均年龄(29.33±3.60)岁;使用左炔诺孕酮时间多在同房后1 d(6例);6例有其他风险因素(注射疫苗或服药)。听取药学咨询门诊药学建议后,1例患者主动选择终止妊娠,其余8例患者选择继续妊娠,其中5例顺利分娩且母婴情况良好(Apgar评分≥9分),3例(异位妊娠、胚胎停育、阴道流血各1例)终止妊娠。文献显示,服用左炔诺孕酮后避孕失败,或在妊娠后无意间使用该药的妊娠妇女均建议继续妊娠。结论药师参与用药咨询门诊可在患者妊娠选择及评价意外妊娠的妊娠结局中发挥重要作用。Objective To provide a reference for further optimizing medication consultation for pregnant patients.Methods Retrieve pregnancy medication consultation data from a certain hospital's medication consultation clinic,pregnancy related medication consultation for 9 patients with failed levonorgestrel contraception from January 2021 to May 2023 were selected,telephone followed-up to understand patients'pregnancy choices and outcomes,combined with literature analysis.Results The average age of the 9 patients with contraceptive failure due to levonorgestrel was(29.33±3.60)years old.Six cases using levonorgestrel for 1 day after sexual intercourse.Six cases with other risk factors(vaccination or take medicine).After receiving pharmaceutical advice from the pharmacy consultation clinic,9 patients initially considered continuing their pregnancy,with 1 patient subjectively choosing to terminate the pregnancy at the beginning.Eventually,5 cases were successfully delivered with good maternal and infant conditions(Apgar score≥9 points),3 patients(1 case each of ectopic pregnancy,embryonic arrest,and vaginal bleeding)terminated their pregnancy.Literature shows that pregnant women who fail contraception after taking levonorgestrel or unintentionally use the drug after pregnancy are advised to continue the pregnancy.Conclusion Pharmacists'participation in medication consultation clinics can play an important role in patients'pregnancy selection and evaluation of unintended pregnancy outcomes.

关 键 词：意外妊娠 药师 左炔诺孕酮 药学服务 用药风险 避孕失败 妊娠结局 

分 类 号：R969.3[医药卫生—药理学]