摘要
患者1年前吞入刀片,在我院行剖腹探查术,术中见肠管破裂穿孔,行"结肠异物取出术+部分小肠、结肠切除术"。术后抗感染治疗4天后自动出院。出院后发热,患者再次入住普外科。腹腔脓液、分泌物培养示大肠埃希菌、肺炎克雷伯菌、粪肠球菌、奇异变形杆菌以及星座链球菌等多种细菌,患者所用药物疗效不佳,临床药师先后两次参加会诊,根据药敏结果和患者病情,建议改用美罗培南联合万古霉素抗感染,临床采纳。治疗期间,药师关注患者用药后各项指标变化。经治疗,患者体温、血常规、C反应蛋白等感染指标逐渐恢复正常,病情得到控制。
One 32-year male patient was admitted to our hospital because of abdominal pain for eight days and intestinal perforation rupture after five days. The patient swallowed a blade one year ago. He un-derwent laparotomy on 09-13 and took colectomy for ruptured bowel perforation. He admitted anti-infection treatment for 4 days and left the hospital. After discharge, the patient got a fever and came back on 09-19. The culture of abdominal pus and secretions showed escherichia coli, klebsiella pneumoniae, enterococ-cus faecalis, proteus mirabilis and streptococcus constellatus. The clinical pharmacists gave pharmacy con-sultation two times, advising the doctor to give the patient meropenem combined with vancomycin for thera-py according to the bacterial culture. The pharmacists gave the patient pharmaceutical care based on the changes of the infectious indicators. After the therapy, the patient＆#39;s body temperature, blood test and C-re-active protein gradually returned to normal. These indicated that the infection became under control.
出处
《药学与临床研究》
2014年第5期446-449,共4页
Pharmaceutical and Clinical Research
关键词
腹腔感染
临床药师
药学会诊
药学监护
Abdominal infection
Clinical pharmacist
Pharmaceutical consultation
Pharmaceutical care
