本文關(guān)鍵詞： 氣性壞疽 抗感染治療 用藥分析 臨床藥師　出處：《中國藥房》2017年29期 　論文類型：期刊論文

【摘要】：目的:探討臨床藥師在氣性壞疽患兒抗感染治療中的作用。方法:臨床藥師參與1例氣性壞疽患兒的抗感染治療過程,根據(jù)患兒臨床癥狀及各科室會診意見,建議使用注射用哌拉西林鈉他唑巴坦鈉初始抗感染治療;患兒經(jīng)左下肢清創(chuàng)引流、壞死組織清除術(shù)后,臨床藥師根據(jù)氣性壞疽的病原學(xué)特點及相關(guān)指南,建議停用注射用哌拉西林鈉他唑巴坦鈉,改用注射用青霉素鈉+注射用亞胺培南西司他丁鈉聯(lián)合抗感染;根據(jù)患兒傷口分泌物細(xì)菌培養(yǎng)及藥敏試驗結(jié)果,建議加用鹽酸克林霉素氯化鈉注射液0.6g,q8 h,ivgtt抑制產(chǎn)氣莢膜梭菌生長;根據(jù)患兒體征及病原學(xué)結(jié)果的改變,先后提出停用鹽酸克林霉素氯化鈉注射液、改用注射用鹽酸萬古霉素等建議。結(jié)果:醫(yī)師采納臨床藥師建議�；純航�(jīng)外科手術(shù)及抗感染治療后,病情好轉(zhuǎn),生命體征平穩(wěn),轉(zhuǎn)入骨科普通病房繼續(xù)治療。結(jié)論:臨床藥師參與氣性壞疽患兒的治療過程,結(jié)合相關(guān)指南以及患兒的臨床癥狀、病原學(xué)檢查結(jié)果、各科室會診意見,協(xié)助醫(yī)師制訂和調(diào)整抗感染治療方案,保證了患兒用藥的安全、有效。
[Abstract]:Objective: to explore the role of clinical pharmacists in anti-infective treatment of children with gas gangrene. Methods: clinical pharmacists participated in the process of anti-infective treatment of one case of gas gangrene, according to the clinical symptoms of children and the consultation opinions of various departments. It was suggested that piperacillin sodium and tazobactam sodium for injection should be used as initial antiinfective therapy, and that the children should be treated with debridement and drainage of the left lower extremity, after the removal of necrotic tissue, according to the etiological characteristics and related guidelines of gas gangrene. It is suggested that piperacillin sodium and tazobactam sodium for injection should be stopped and imipenem cilastatin sodium for injection should be used instead of imipenem sodium for injection. It is suggested to add clindamycin hydrochloride sodium chloride injection 0.6 g / g Q 8 h iv GTT to inhibit the growth of Clostridium perfringens, according to the changes of children's physical signs and etiological results, the discontinuation of clindamycin hydrochloride sodium chloride injection was put forward successively. Results: doctors accepted the advice of clinical pharmacists. After surgery and anti-infection treatment, the child's condition improved and the vital signs were stable. Conclusion: clinical pharmacists are involved in the treatment of children with gas gangrene, combined with the relevant guidelines and clinical symptoms, etiological examination results, consultation opinions of each department, Assist doctors to formulate and adjust anti-infection treatment program to ensure the safety and effectiveness of drug use in children.
【作者單位】： 重慶醫(yī)科大學(xué)附屬永川醫(yī)院藥學(xué)部;
【基金】：重慶醫(yī)科大學(xué)附屬永川醫(yī)院院內(nèi)科研課題資助項目(No.YJQN201431)
【分類號】：R725.1

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