唐景财，阎　敏(1.桂林市人民医院药剂科，广西 桂林　541002； 2.中南大学湘雅医院药剂科，湖南 长沙　410008)



临床药师参与1例肾病综合征并发胃肠道感染患者的药学监护

唐景财1*，阎敏2 #(1.桂林市人民医院药剂科，广西 桂林541002； 2.中南大学湘雅医院药剂科，湖南 长沙410008)

DOI10.14009/j.issn.1672-2124.2016.02.045

摘要目的：探讨临床药师在肾病综合征患者合理用药中的作用。方法：介绍临床药师参与1例肾病综合征并发胃肠道感染患者的治疗过程。结果与结论：经临床药师与医师讨论并选择合适的药物，根据患者病情变化及药物疗效及时调整用药方案，可为患者提供必要的药学服务。结果，该患者尿蛋白减少，未出现血栓等并发症，胃肠道感染治愈。由此表明，临床药师参与患者有关治疗方案的制订，可提高患者的用药依从性和临床治疗效果，医疗质量提升，临床药师在肾病综合征患者合理用药中发挥了重要作用。

关键词临床药师； 肾病综合征； 感染； 药学实践

Clinical Pharmacists’ Practice in Pharmaceutical Care for One Nephrotic Syndrome Patient with Gastrointestinal Infection

TANG Jingcai1, YAN Min2(1.Dept.of Pharmacy, People’s Hospital of Guilin, Guangxi Guilin 541002, China; 2.Dept.of Pharmacy, Xiangya Hospital of Central South University, Hunan Changsha 410008, China)

ABSTRACTOBJECTIVE：To explore the role of clinical pharmacists in clinical rational drug use for nephrotic syndrome patients. METHODS: To introduce the treatment process of one nephrotic syndrome patient with gastrointestinal infection participated by the clinical pharmacists. RESULTS & CONCLUSIONS: Proper drugs were selected through the discussion of clinical pharmacists and clinicians, the medication scheme was adjusted according to the patient’s conditions and clinical efficacy of drugs, and necessary pharmaceutical care was provided for the patient. Meanwhile, the patient’s urinary protein decreased without any complications like thrombus, and the gastrointestinal tract infection had been cured. Therefore, clinical pharmacists‘ participation in the formulation of the related treatment regimen can improve patient’s compliance and clinical treatment efficacy and also promote medical quality. The clinical pharmacists play an important role in the rational drug use for nephrotic syndrome patients.

KEYWORDSClinical pharmacists; Nephrotic syndrome; Infection; Pharmaceutical practice

肾病综合征是一种由多种病因引起的、多种病理改变导致的以肾小球病变为主的一组临床综合征，临床表现为大量蛋白尿(≥3.5 g/d)、低白蛋白血症(≤30 g/L)、水肿和高脂血症[1]。感染为其严重并发症之一，会使肾病综合征易于复发，增加治疗难度和病死率[2]。同时，低蛋白血症导致血液胶体渗透压下降引起血液浓缩；高脂血症引起血液黏稠；加之机体凝血和纤溶系统失衡等加重高凝状态。因此，对于肾病综合征患者，对因治疗和对症治疗都至关重要。作为肾内科的临床药师，应积极参与临床药物治疗方案设计，根据患者的疾病情况进行药物鉴别选择使用，并为患者提供有效的药学服务，促进临床用药合理、安全、有效。……