一例脑出血、肝硬化失代偿期合并肺炎病人的抗感染治疗策略分析

Analysis and evaluation of the anti-infective treatment of a patient with cerebral hemorrhage and decompensated cirrhosis combined with pneumonia

目的:探讨肝功能不全合并严重感染的危重患者抗菌药物选择策略,为临床合理用药提供参考。方法:通过一例脑出血、肝硬化失代偿合并肺炎病人抗感染治疗的案例,分析在肝功能严重受损时抗菌药物治疗方案的调整,制定适合的个体化给药方案。结果:临床药师对严重肝功能受损患者的抗菌药物应用开展全程化的药学监护,针对患者病程中不同阶段存在的不同致病菌,对抗感染治疗方案进行调整,使患者肺部感染得到有效控制。结论:临床药师在临床实践中,关注肝功能不全患者的抗菌药物选择并进行药学监护,发挥药学专业优势,可以预防和减少不良反应的发生,改善患者预后。

AIM： To explore the selection strategy of antibiotics in the critically infected patient with severe liver dysfunction. METHODS： Clinical pharmacist participated in the anti-infection treatment process of a patient with cerebral hemorrhage and decompensated cirrhosis combined with lung infection,analyzed the pathogen combined with the clinical condition,chose the type of antibactierial drugs and give dosage adjustment according to the essential principle of antibacterial and the patient ’s liver function state. RESULTS： The patient’s pulmonary infection were controlled effectively by the several adjustment of anti-infection treatment plan. The patient was successfully recovered. CONCLUSION： Clinical pharmacists participated in the choice of antimicrobial drugs in patients with liver dysfunction and carry out pharmaceutical care in participating clinical. These are profession advantage of clinical pharmacist,which can reduce drug adverse reaction and improve the prognosis of patients.