临床药师参与抗菌药物相关性腹泻治疗的药学研究

Pharmaceutical research on clinical pharmacists participating in treatment of antibiotic associated diarrhea

目的探讨临床药师在临床药物治疗中所发挥的作用。方法回顾分析该院2013—2015年20例抗菌药物相关性腹泻病例特点和临床药师参与治疗的资料。结果20例患者，治愈19例，死亡1例，死亡患者因其伴发肝门胆总管癌，尽管口服使用了去甲万古霉素治疗，在腹泻症状好转后，还是未能挽救患者的生命。其余患者停用原抗菌药物，加用口服去甲万古霉素0.4g，每6小时1次。同时服用调整肠道菌群的药物（布拉氏酵母菌或干酵母）和胃黏膜保护剂（蒙脱石散）。结论临床药师能协助医师确定或调整用药方案，其在医疗团队中的作用正逐渐被临床认可。

Objective To discuss the role of clinical pharmacists playing in clinical medication treat- ment. Methods The characteristics of 20 cases of antibiotic associated diarrhea in our hospital from 2013 to 2015 and the data of the clinical pharmacists participating in the treatment were retrospectively analyzed. Re- suits Among 20 cases, 19 cases were cured,but 1 case died due to complicating porta common bile duct cancer, although taking demethylvancomycin,the patient＇s life was not rescued after the diarrhea symptoms improvement. Other cases stopped original antibacterial drugs and took oral demethylvancomycin 0.4 g, once per 6 h. A the same time the drugs for adjusting intestinal flora （Saccharomyces boulardii or Saccharated Yeast Tablets） and gastric mucosal protective agent （Montmorillonite Powder）. Conclusion The clinical pharmacists can assisted doctor determine or adjust the medication scheme, their role in the medical team is gradually accepted by clinic.