1例妊娠期亚临床甲状腺功能减退合并贫血、痔疮患者的药学监护

Pharmaceutical Care for One Case of Subclinical Hypothyroidism Complicated with Anemia and Haemorrhoids during Pregnancy

目的:探讨对妊娠期亚临床甲状腺功能减退合并贫血、痔疮患者的治疗方案及药学监护思路。方法:通过1例妊娠期亚临床甲减合并贫血、痔疮患者的药物治疗过程进行药学监护,并总结分析。结果:临床药师对患者的妊娠期亚临床甲减、贫血、痔疮治疗过程进行监护,并对期间口服补铁治疗贫血效果不佳时进行分析、探讨,提出合理建议。结论:妊娠期亚临床甲减患者合并贫血、痔疮等,在补充铁剂、小麦纤维素颗粒等药物治疗时,必须注意药物的相互作用,左甲状腺素钠应与铁剂和小麦纤维素颗粒错开至少2h时之上服用。因甲减致铁吸收障碍,当口服补充铁剂效果不佳时可考虑静脉铁剂治疗。

Objective ： To discuss the effective therapeutic regimen and the thoughts of pharmaceutical care for subclinical hypothyroidism complicated with anemia and hemorrhoids during pregnancy. Methods： During the drug treatment process, clinical pharmacist provided pharmaceutical care for the patient, and the results were summarized and analyzed. Results： Clinical pharmacist performed pharmaceutical care for the treatment process of hypothyroidism, anemia and hemorrhoids during pregnancy, and when the oral iron treatment of hemorrhoids was with poor efficacy, clinical pharmacist analyzed and discussed the reasons and put forward reasonable suggestions. Conclusion： Subclinical hypothyroidism complicated with anemia and hemorrhoids during pregnancy treated with iron agent and wheat cellulose particles must pay attention to the drug interactions. The administration time of levothyroxine sodium and that of iron preparations and wheat cellulose particles should be staggered at least 2 hours. Because hypothyroidism can cause iron malabsorption, intravenous iron therapy may be considered when oral iron supplementation shows poor effect.