临床药师参与1例慢性胰腺炎急性发作患者ERCP术后败血症的治疗实践

Practice of Clinical Pharmacists Participating in Sepsis Treatment for a Patient with Acute Attack of Chronic Pancreatitis after ERCP

目的:总结临床药师参与慢性胰腺炎急性发作患者内镜下逆行胰胆管造影术(ERCP)后败血症治疗的经验。方法:临床药师通过参与1例慢性胰腺炎急性发作患者ERCP术后败血症患者的会诊工作,针对患者治疗过程中出现的反复发热,临床药师先后建议给予头孢哌酮/舒巴坦3.0 g,ivgtt,q8 h;亚胺培南0.5 g,ivgtt,q8 h或q6 h;注射用哌拉西林/他唑巴坦钠4.5 g,ivgtt,q8 h;针对抗菌药物性相关性腹泻临床药师建议停用抗生素并加用布拉氏酵母菌0.5 g,po,bid调节肠道菌群。结果:经过43 d的治疗,患者的感染及腹泻得到控制,病情好转出院。结论:临床药师参与临床诊疗有利于患者的康复。

OBJECTIVE： To summarize the experience of clinical pharmacists participating in sepsis treatment for a patient with acute attack of chronic pancreatitis after endoscopic retrograde cholangiopancreatography （ERCP）. METHODS： Through participating in consultation of sepsis treatment for a patient with acute attack of chronic panereatitis after ERCP, according to repeated fever during treatment, clinical pharmacists suggested using cefoperazone and sulbactam 3.0 g, ivgtt, q8 h; imipenem 0.5 g, ivgtt, q8 h or q6 h; Pailaxilinna/Tazobactam sodium for injection 4.5 g, ivgtt, q8 h. Due to antibiotics-related diarrhea, clinical pharmacist advised to stop taking antibiotics but use Saccharomyces boulardii 0.5 g, po, bid additionally to regulate intestinal microflora. RESULTS： After 43 days of treatment, the infection and diarrhea had been controlled, and the patient discharged from the hospital after recovery. CONCLUSIONS： The participation in clinical treatment by clinical pharmacists is conducive to the rehabilitation of patients.