临床药师对主动脉内球囊反搏术后患者的药学监护

Pharmaceutical Care for Patients Implanted with Intra-aortic Balloon Pump by Clinical Pharmacists

目的:探讨临床药师参与药物治疗及开展药学监护的切入点。方法:对2012年10月-2013年7月期间行主动脉内球囊反搏(IABP)术治疗的33例患者进行药学监护,临床药师开展了多方面的药学监护,包括抗栓治疗监护、肾功能监护、预防感染、药物相互作用监护等。结果:多数患者发生轻微的指标异常或不适,有并发症或药品不良反应者共10例,其中1例患者同时发生血小板下降和肌酐升高,2例患者发生的指标异常及不适症状经鉴别为药品不良反应所致。药学监护的开展帮助医师及时发现术后并发症和药品不良反应,优化了治疗方案,取得较好效果。结论:行IABP术的患者可能出现血小板减少、肾功不全、感染等并发症,且此类患者病情危重、应用药物品种繁多、药物相互作用及不良反应发生几率较大,临床药师可从这些方面入手开展药学服务,保证患者用药安全,提高药物治疗水平。

OBJECTIVE： To explore the methods of clinical pharmacists participating in drug therapy and developing pharmaceutical care. METHODS： Clinical pharmacist supplied pharmaceutical care for 33 patients implanted with intra-aortic balloon pump （IABP） from Oct. 2012- Jul. 2013 in respects of antithrombotic therapy, renal function monitoring, infection prevention, drugs interactions, etc. RESULTS： Most of patients suffered from slight abnormalities or disorder; there were 10 patients with indications or ADR, among which a patient suffered from the decrease of platelet and the increase of creatinine, and 2 cases of abnormal index and disorder were caused by ADR. The development of pharmaceutical care helped the physicians to discover postoperative indications and ADR timely and optimize therapeutic scheme so as to obtain good therapeutic efficacy. CONCLUSIONS ： The patients underwent IABP may suffer from thrombocytopenia, renal insufficiency, infection, etc. They often show the symptoms of disease severity and adopted multiple drugs, and were more likely to suffered from drug interaction and ADR. Clinical pharmacists should provide pharmaceutical care for patients from above aspects to guarantee the safety of drugs and improve drug treatment.