肿瘤外科药学工作模式探索

Exploration of the Working Mode of Oncology Surgical Pharmacy

尽管抗肿瘤治疗的手段越来越多,但仍有约60%以上的实体瘤以外科手术治疗为主,外科对于肿瘤的预防、诊断、分期、重建和康复都起着无可替代的作用。但手术过程对患者身体的影响,抗肿瘤治疗、共病治疗的复杂性,以及诸多药物治疗管理的细节,在外科实践中常常难以被医护人员兼顾,而且既往肿瘤专科临床药师的培养与开展的药学监护服务更多地聚焦于内科治疗系统,在外科领域涉猎不多,目前尚未形成肿瘤外科药学工作模式与工作体系,在外科肿瘤患者全程化管理方面还存在值得探索与提升的领域。本文着重阐述外科药师作为多学科诊疗团队成员,以患者为中心,以加速康复外科为基础,全面覆盖外科治疗各时间节点的抗肿瘤、抗感染、麻醉、抗凝、血压、血糖、营养、疼痛管理等工作要点,构建基于满足患者个体化治疗需求的肿瘤外科全程化药学监护路径,为肿瘤外科药师开展规范化、标准化、同质化的药学服务提供理论和技术支撑,以期为规范肿瘤外科疾病诊疗,提高患者生存质量,提升肿瘤外科治疗绩效提供参考。

At present,although there are more and more methods to treat tumors,more than 60%of solid tumors are mainly treated by surgery,surgery plays an irreplaceable role in the prevention,diagnosis,staging,reconstruction and rehabilitation in tumor treatment.However,surgery can affect the patient?s body,accompanied with complex treatments for tumor and comorbidities,so it is very difficult for surgeons and nurses to take into account many details in medication therapy management for patients in the real work.In the past,the training of clinical pharmacists in oncology and the development of pharmaceutical care focused more on the internal medicine treatment system,not much involved in the surgical field,therefore,the mature mode and complete system for oncology surgical pharmacy have not yet been formed.In conclusion,as a member of Multidisciplinary Clinic Team,based on accelerated rehabilitation surgery,surgical pharmacists are patient-centered,covering the key points of anti-tumor,anti-infection,anesthesia,anticoagulation,blood pressure,blood glucose,nutrition,pain management,etc.at all-time points related to surgical treatment,to construct the full-process monitoring path for patients receiving oncology surgical treatment to meet the needs of individualized treatment,meanwhile,to provides theoretical and technical support for the standardized and homogeneous pharmaceutical care for oncology surgical pharmacists.The aim is to standardize the diagnosis and treatment for oncology surgical,improve the quality of life of patients and improve performance management.