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1、www.zgys.org药物与临床临床药师参与1例多药耐药鲍曼不动杆菌感染治疗的体会12贾立华李忠东(1.解放军307医院药学部北京100071;2.空军总医院药学部)摘要目的:探讨临床药师进行SOAP模式药学会诊中的思维训练与经验积累过程。方法:对1例食管癌术后鲍曼不动杆菌肺炎患者进行病情变化评估,3次受邀会诊,建议药物治疗方案,监护药物治疗结果,连续1个月主动追踪并回访患者的病情转归结果。结果:鲍曼不动杆菌的初始判断与经验治疗后,感染有所好转,随着病情变化,及时调整治疗方案,依据病情和感染严重程度给予最适当的药物治疗方案,感染有效控制,
2、术后治疗35d出院。结论:临床药师会诊应首先判断病情,对前期治疗结果进行总结评估,再针对PK/PD特点选择药物,并不断追踪治疗结果,才能准确评估病情,做到个体化给药。关键词案例分析;临床药师;SOAP会诊中图分类号:R97文献标识码:A文章编号:1008-049X(2015)05-0816-03ParticipationExperienceofClinicalPharmacistintheTreatmentofOnePatientwithMultidrugResistantAcinetobacterbaurnanniiInfection12
3、JiaLihua,LiZhongdong(1.DepartmentofPharmacy,the307thHospitalofPLA,Beijing100071,China;2.DepartmentofPhar-macy,GeneralHospitalofAirForce,PLA)ABSTRACTObjective:TodiscusstheexperienceaccumulationandthinkingtrainingofclinicalpharmacistinthepharmaceuticalconsultationwithSOAPmod
4、el.Methods:ClinicalpharmacistperformedtheconditionevaluationforonepatientwithAcinetobacterbau-rnanniiinfectionafteresophaguscancersurgeryandwasinvitedtotheconsultationforthreetimes.Clinicalpharmacistalsoprovidedthereferencesforthedrugtreatmentandmonitoredthewholeprocess.Cl
5、inicalpharmacistactivelyfollowedandpaidreturnvisitsfortheprognosisofthepatientforonemonth.Results:Afteridentifyingthepathogen,theexperientialtherapywasgivenandthecondi-tionsofthepatientwereimproved.Accordingtothechangesoftheconditions,thetreatmentwasadjustedintimewiththemo
6、stsuitabledrugsfortheconditionsandinfectiondegree.Finally,theinfectionwascontrolledeffectively,andthepatientwasdischargedafterthe35-daypostoperativetreatment.Conclusion:Duringtheconsultation,clinicalpharmacistshouldcorrectlyjudgetheconditionsofpa-tients,summarizeandevaluat
7、etheearliertherapyresults,andthenchoosesuitabledrugsaccordingtothepropertyofPK/PD.Clinicalpharmacistalsoshouldtrackthetherapyresultstoassesstheconditionsofpatientsandindividualizethetreatment.KEYWORDSCaseanalysis;Clinicalpharmacist;SOAPconsultation国内外的临床药师教学药历书写中,SOAP(subj
8、ective:主和对方案制定后实施药学监护的持续性,目前采用SOAP模[1]观性资料;objective:客观性资料;assessment:分析和评估;式引导重症感染会诊思维和书
