临床药师参与会诊90例感染病例的分析

Clinical Pharmacists' Involvement in Consultation:Analysis of 90 Infective Cases

目的:了解临床药师参与会诊的实际情况和结果,为药师更好地参与临床实践提供依据。方法:对2011年1—10月临床药师参与会诊的90例感染病例会诊登记表进行统计分析。结果:在90例病例中,会诊原因为制定抗感染治疗预案为10例(占11.1%),要求调整或审查原治疗方案为80例(占88.9%);对于临床要求调整或审查的80例,临床药师总共给出101条针对抗菌药物应用的意见(人均1.26条)以及22例次抗感染相关处理意见;临床药师会诊意见为切换品种者34例(占33.6%),继续使用为19例(占18.8%),停用或部分停用为12例(占11.9%)。会诊意见被临床全部采纳者77例(占85.6%),部分采纳为13例(占14.4%),未采纳0例。意见采纳后再行治疗,痊愈33例(占36.7%),好转49例(占54.4%),效果不明显5例(占5.6%),死亡或放弃治疗3例(占3.3%)。结论:临床药师会诊已经成为临床治疗工作的一部分,药师应不断学习临床和药学知识,总结经验,提高会诊质量,进而参与到各专科合理用药中去。

OBJECTIVE：To probe into the practice and results of clinical pharmacists＇ consultations so as to provide reference for pharmacists to participate in clinical practice in the future. METHODS：The registration forms of consultations participated by clinical pharmacists for a total of 90 infective cases during Jan. -Oct. period of 2011 were analyzed statistically. RESULTS ： Of the 90 cases, 10 （ 11.1% ） received consultation for establishing an anti-infective therapy and 80（88.9% ） for requirement to adjust the original treatment plan. Clinical pharmacists came up with 101 suggestions（ 1.26 per capita） on antibiotic use for the 80 eases requiring adjustment or check of treatment plan and 22 suggestions .on anti-infective management. Clinical pharmacists＇ suggestions given during consultation included switching antibiotics for 34 patients （33.6%）, continuing drug use in 19 （ 18.8 % ） and drug withdrawal or withdrawal of certain drugs in 12 （ 11.9% ）. Clinical pharmacists＇ suggestions were thoroughly accepted by 77 cases （ 85.6% ）, partially taken by 13 cases （ 14. 4% ） vs. unadopted by none. With the treatment established based on pharmacists＇ suggestions, 33 cases（36. 7% ） were classified as cured, 49（54. 4% ） took a favorable turn, 5 （5.6%） had little response and 3 （3.3%） died or gave up treatment. CONCLUSION： Clinical pharmacists＇ consultation has already become an indispensable part of clinical work. Pharmacists should improve their clinical and pharmaceutical knowledge and gather experiences to improve the quality of consultation so as to contribute to clinical rational drug use.