对冠心病合并房颤老年病人经皮冠脉介入术后出血的药学服务

Pharmaceutical care of one senile patient undergoing percutaneous coronary intervention with complicated coronary heart disease/atrial fibrillation and post-operative hemorrhage

目的:探讨冠心病合并房颤老年病人行经皮冠脉介入(percutaneous coronary intervention,PCI)术后出血的药学服务内容,以及临床药师参与个体化药物治疗的模式。方法:临床药师参与心血管内科一例冠心病合并房颤PCI术后出血的老年病人的治疗全过程,对其进行个体化用药服务,主要涉及出血情况的服务,抗栓药物、抗心律失常药物和抗心绞痛药物使用的个体化调整与优化。结果:病人出血情况得到控制,病情好转后出院。结论:临床药师通过参与临床实践,利用药学特长对于复杂病例实施个体化药学服务,体现了自身价值。

Objective：To explore pharmaceutical care of one senile patient undergoing percutaneous coronary intervention（PCI）with complicated coronary heart disease/atrial fibrillation and post-operative hemorrhage and the mode of involvement on the part of clinical pharmacists in individualized drug treatment.Methods：Clinical pharmacists were involved in the whole treatment course of one senile patient with coronary heart disease complicated with atrial fibrillation and post-operative hemorrhage,and provided individualized pharmaceutical care,including individualized drug regulation and optimization in the treatment for hemostasis,embolism,arrhythmia and stenocardia.Results：Hemorrhage was effectively brought under control and the patient was discharged from hospital,when the conditions were improved.Conclusion：Through clinical practice and by bringing their specialty into full play,clinical pharmacists could display their own personal value in individualized pharmaceutical care for the treatment of complicated cases.