手术后大面积肺栓塞合并铜绿假单胞菌血症的治疗分析与药学监护.pdfVIP

实用药物与临床2013年第16卷第12期　 Practical Pharmacy And Clinical Remedies,2013,Vol.16,No.12 ·1197 · 手术后大面积肺栓塞合并铜绿假单胞菌血症的治疗分析与药学监护 1 1 1 1 2∗ 林　 茵 ,伍俊妍 ,赵文霞 ,廖日房 ,陈　 杰 　 　 [摘　 要]　 目的　 探讨肺栓塞患者的个体化治疗方案。 方法　 对手术后发生大面积肺栓塞患者使用华法 林抗凝治疗进行分析,提出个体化治疗方案及监护要点。 结果　 经抗凝治疗后,患者国际标准化比值(INR)达到 2~3,病情好转稳定出院。 结论　 临床药师应对肺栓塞患者抗凝治疗及时进行个体化用药监护,提出适当干预, 以协同临床优化治疗方案,保障合理有效安全用药。 [关键词]　 肺栓塞;华法林;铜绿假单胞菌血症;药学监护;临床药师 Curative effect analysis and pharmaceutical care for the patient with massive pul- monary embolismandpseudomonasaeruginosainfectionsaftersurgery　 1 LINYin ,WU 1 1 1 2∗ Jun-yan ,ZHAOWen-xia ,LIAO Ri-fang ,CHEN Jie (1.Sun Yat-sen Memorial Hospital,Sun Yat-sen University, Guangzhou510120,China;2.The First Affiliated Hospital of Sun Yat-sen University,Guangzhou510280,China) 　 　 [Abstract]　 Objective　 Toexploretheindividualizedtreatmentplansfor thepatient withpulmonary embolism. Methods　 An analysis of warfarin anticoagulation therapy was performed for patient with massive pulmonary embol- ism and pseudomonasaeruginosa infectionsafter surgery,individualizedtreatment plansandpharmaceutical care meas- ures were alsoproposed.Results　 Patient was curedand dischargedafter anticoagulationtherapy with theinternational normalized ratio(INR)reaching2~3.Conclusion　 Clinical pharmacist should provide the individualized anticoagula- tion therapy and appropriate intervention for the patients with pulmonary embolism to optimize the clinical treatment, and to guarantee the use of drug reasonable,safe and effective. Key words:Pulmonary embolism;Warfarin;Pseudomonasaeruginosa;Pharmaceutical care;Clinical pharmacist 　 　 肺栓塞(Pulmonary embolism,PE)是指各种栓 脉、双下肺动脉主干及各基底段动脉管腔内见多 子阻塞肺动脉系统为其发病原因的一组疾病或临 发块状充盈缺损影,右肺下叶局部