【摘要】：目的:探討臨床藥師在圍產(chǎn)期危重患者藥物治療中的作用。方法:臨床藥師參與4例圍產(chǎn)期危重患者的藥物治療過(guò)程,結(jié)合妊娠期及妊娠后特殊的病理生理狀況(如尿素循環(huán)障礙、血脂異常、嚴(yán)重感染和循環(huán)血容量不能快速恢復(fù)等),在權(quán)衡治療矛盾的基礎(chǔ)上,結(jié)合相關(guān)指南和文獻(xiàn)在藥物選擇、用藥時(shí)機(jī)、用藥療程、聯(lián)合用藥、劑量調(diào)整等方面,針對(duì)性地給出選用頭孢呋辛、還原型谷胱甘肽、熊去氧膽酸等藥物,及時(shí)停藥或調(diào)整抗菌藥物治療方案等個(gè)體化用藥建議,并行實(shí)驗(yàn)室指標(biāo)檢測(cè)及不良反應(yīng)監(jiān)測(cè)等藥學(xué)監(jiān)護(hù)。結(jié)果:醫(yī)師采納臨床藥師建議,4例患者病情均好轉(zhuǎn)。結(jié)論:臨床藥師在參與圍產(chǎn)期危重患者藥物治療的過(guò)程中,應(yīng)選擇安全、有效的治療藥物,并根據(jù)其臨床癥狀及時(shí)調(diào)整用藥方案;當(dāng)用藥安全性與藥物有效性矛盾時(shí),應(yīng)充分權(quán)衡利弊,確保孕婦和胎兒的生命安全。
[Abstract]:Objective: to explore the role of clinical pharmacists in the treatment of perinatal critical patients. Methods: clinical pharmacists participated in the treatment of 4 perinatal critical patients, combined with the special pathophysiological conditions during pregnancy and after pregnancy (such as urea circulatory disorder, dyslipidemia). Serious infection and rapid recovery of circulating blood volume, etc.) on the basis of weighing treatment contradictions, combining relevant guidelines and literature on drug selection, timing, course of treatment, combined use of drugs, dose adjustment, etc. Individualized drug suggestions such as cefuroxime, reduced glutathione, ursodeoxycholic acid and so on were given. Results: all the 4 patients were improved according to the advice of the clinical pharmacist. Conclusion: clinical pharmacists should choose safe and effective drugs in the course of taking part in the treatment of perinatal critical patients, and adjust the regimen according to their clinical symptoms. The pros and cons should be fully weighed to ensure the safety of pregnant women and fetuses.
【作者單位】： 上海交通大學(xué)醫(yī)學(xué)院附屬新華醫(yī)院藥學(xué)部;上海交通大學(xué)醫(yī)學(xué)院附屬新華醫(yī)院外科重癥監(jiān)護(hù)病房;
【基金】：新華醫(yī)院院級(jí)臨床研究項(xiàng)目(No.15LC11)
【分類(lèi)號(hào)】：R714.7

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