围产期危重症患者药物治疗分析与药学监护

发布时间：2018-08-03 21:33

【摘要】：目的:探讨临床药师在围产期危重患者药物治疗中的作用。方法:临床药师参与4例围产期危重患者的药物治疗过程,结合妊娠期及妊娠后特殊的病理生理状况(如尿素循环障碍、血脂异常、严重感染和循环血容量不能快速恢复等),在权衡治疗矛盾的基础上,结合相关指南和文献在药物选择、用药时机、用药疗程、联合用药、剂量调整等方面,针对性地给出选用头孢呋辛、还原型谷胱甘肽、熊去氧胆酸等药物,及时停药或调整抗菌药物治疗方案等个体化用药建议,并行实验室指标检测及不良反应监测等药学监护。结果:医师采纳临床药师建议,4例患者病情均好转。结论:临床药师在参与围产期危重患者药物治疗的过程中,应选择安全、有效的治疗药物,并根据其临床症状及时调整用药方案;当用药安全性与药物有效性矛盾时,应充分权衡利弊,确保孕妇和胎儿的生命安全。
[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.
【作者单位】：上海交通大学医学院附属新华医院药学部;上海交通大学医学院附属新华医院外科重症监护病房;
【基金】：新华医院院级临床研究项目(No.15LC11)
【分类号】：R714.7

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