1例急性胰腺炎孕妇并发血流感染的临床特征及其药学监护

Clinical Characteristics of Bloodstream Infection in a Pregnant Woman with Acute Pancreatitis and Its Pharmaceutical Care

目的:分析急性胰腺炎孕妇并发血流感染的临床特征及其药学监护过程,为类似病例的处置提供参考。方法:临床药师参与1例30岁孕34周妊娠期(因进食后腹痛加剧)被外院诊断为急性胰腺炎的孕妇,协助临床制定治疗方案(予禁食、哌拉西林-他唑巴坦与万古霉素抗感染、生长抑素抑酶、奥美拉唑抑酸、补液等)治疗后,分析淀粉酶增高的原因和治疗对策,并实施药学监护。结果:临床药师参与临床治疗后,行剖宫产术孕妇娩出一活女婴,手术后转入ICU,后续治疗又转回产科,病情得到有效改善。结论:临床药师协助临床治疗方案的制定,并实施药学监护,提高了降脂及抗感染等药物的合理用药水平,避免了不良反应的发生。

Objective: To analyze the clinical characteristics of bloodstream infection in a pregnant woman with acute pancreatitis and its pharmaceutical care so as to provide reference for the treatment of similar cases. Methods:The clinical pharmacist participated in a 30-year-old pregnant woman diagnosed as acute pancreatitis at 34 weeks of gestation due to the aggravation of abdominal pain after eating, and assisted in the clinical formulation of treatment plan(fasting, piperacillin-tazobactam and vancomycin anti-infection, somatostatin enzyme inhibition, omeprazole acid inhibition, fluid rehydration, etc.). The causes of amylase increase and treatment were analyzed, and pharmaceutical care was carried out. Results: After the clinical pharmacists participated in the clinical treatment, the pregnant woman who underwent cesarean section delivered a live girl baby. After the operation, she was transferred to ICU, and after treatment, her condition was effectively improved and she was referred back to the obstetrics department for further treatment. Conclusion: That clinical pharmacists assist in making therapeutic schedules and implement pharmaceutical care improve the rational use of lipid-lowering and anti-infection drugs and avoid the occurrence of adverse reactions.