临床药师参与产科肝功能异常患者保肝药使用会诊及典型案例分析

Clinical Pharmacists’Participation in Consultations on the Use of Hepatoprotective Drugs inPatients with Abnormal Liver Function in Obstetrics and Analysis of Relevant Typical Cases

目的为产科临床药师参与临床药物治疗实践提供参考。方法收集并分析四川省妇幼保健院2018年至2019年产科临床药师参与肝功能异常患者保肝药用药会诊病例及其中的典型案例。结果导致妊娠期及哺乳期合并肝功能异常常见病因有妊娠期肝内胆汁淤积症、妊娠合并病毒性肝炎、药物性肝损伤、妊娠期高血压等,发病孕周以晚期妊娠为主;临床药师共参与产科保肝药的使用会诊146例,经保肝药方案制订和用药剂量调整会诊病例的有效率明显高于未会诊病例(P<0.05)。结论妊娠期及哺乳期保肝药的合理使用是产科临床药师深入开展临床药学工作的切入点。通过药学会诊,临床药师优化了患者的药物治疗方案,提高了疗效,降低了药品不良反应发生率,保障了母儿安全。

Objective To provide a relerence for elinical phamacists in obstetris to participate in clinical drug therap.Methods Theconsulation cases and the typical cases of hepatoprotective dnugs for patients wih abnormal liver function participated by clinical phar-macists in obstetrics from 2018 to 2019 in Sichuan Provincial Matermnity and Child Health Care Hosital were collected and analyzed.Results'The common causes of abnormal liver function during pregnancy and lactation include&intrahepatic cholestasis of pregnancy(ICP),pregnancy with viral hepatis,drnug-induced liver injury,and gestational hypertension.The onset gestational week was mainly inthe thind trimester.The clinical pharmacists have paticipated in an overal of 146 consulation cases on the use of obstetric hepatopro-tective drugs.T'he effective rate of patients with consultations after the formulation of hepatoprotective drugs plan and the adjustment ofmedication dosage was higher than that of patients without consultation(P<0.05).Conclusion The rational use of hepatoprotective drugs during pregnancy and lactation is the key point for clinical pharmacists in obstetrics to carry out clinical pharmacy work in depth.Through the pharmacy consulation,the clinical pharmacist optimized the patient's drug treatment plan,which can improve the cura-tive effect and reduce the incidence of adverse drug reactions,and also ensure the safety of mother and child.