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目的探讨临床药师在肾移植术后感染伴发严重骨髓抑制患者的治疗中进行的用药分析与药学监护。方法临床药师参与1例肾移植术后感染伴发严重骨髓抑制患者的用药分析以及判定药物不良反应/事件,提供抗感染药物调整的建议和药学监护。结果患者停用骨髓抑制风险较大的缬更昔洛韦和复方磺胺甲(口恶)唑后,并立即使用升高血细胞的治疗药物,治疗第10天血细胞水平开始逐渐上升,病情得到控制。结论临床药师对患者用药进行分析,及时发现和解决了患者药物治疗中的问题,为临床合理用药提供建议,并进行药学监护,密切关注患者的临床症状和药物的疗效,提高了治疗效果。
Objective To investigate the clinical pharmacists’ medication analysis and pharmacy care in the treatment of patients with severe myelosuppression after renal transplantation. Methods Clinical pharmacists participated in the analysis of drug use in 1 patient with renal transplantation infection complicated with severe myelosuppression and the determination of adverse drug reaction / events, and provided suggestions for the adjustment of anti-infective drugs and pharmacy care. Results After the patients were stopped using valganciclovir and compound sulfamethoxazole with a higher risk of myelosuppression, the blood cells were immediately treated with hematopoietic drugs. On the 10th day of treatment, blood cell levels began to rise and the disease was controlled. Conclusion Clinical pharmacists analyzed patients ’medication, found and solved the problems of drug therapy in time, provided suggestions for clinical rational drug use, carried out pharmacy care, paid close attention to the patients’ clinical symptoms and drug efficacy, and improved the treatment effect.