临床药师参与1例血液透析导管相关性感染患者的治疗实践

Analysis of Clinical Pharmacists Participating in Drug Treatment for a Hemodialysis Patient with conduit Infections

目的：从药学角度探讨临床药师在参与1例血液透析导管相关性感染患者中的作用.方法：临床药师分析患者感染来源,并结合患者症状、微生物学检查结果选用万古霉素,同时根据患者血液透析方式及万古霉素特性选择用法用量.结果：患者在8~10天体温明显下降,第10日降钙素原（PCT）降为0.7ng/mL,监测万古霉素血药浓度为18.7mg/mL,可继续维持临床药师推荐用法继续治疗.结论：临床药师参与患者抗感染方案的制定,能从专业角度给予医师和患者良好的药学服务.

Object： To investigate the strategies of clinical pharmacists participating in drug treatment for hemodialysis patients.Methods： Clinical pharmacists analyzed the infection resources, and selected vancomycin on the basis of symptom and the result of microbiological examination, and constitute the dose of vancomycinon on the basis of pattern of hemodialysis.Results： The patient＇s temperature decreased significantly in 8 ~ 10 days. On the tenth day, procalcitonin （PCT）reduced to 0.7ng/ml, serum concentration of vancomycin was 18.7mg/ml, which can be continued to maintain the recommended use by clinical pharmacists.Conclusion： Clinical pharmacists can offer better service for doctor and patient.