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临床药师在ICU感染性休克患者抗感染治疗中的作用
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| 篇名： | 临床药师在ICU感染性休克患者抗感染治疗中的作用 |
| TITLE： | Role of Clinical Pharmacists in Anti-infective Therapy for Patients with Septic Shock in ICU |
| 摘要： | 目的：探讨临床药师在重症加强护理病房（ICU）抗感染性休克治疗中的作用。方法：回顾性收集2018年1－12月重庆市黔江中心医院ICU收治的感染性休克患者180例，按照临床药师是否全程参与抗感染治疗分为干预组（92例）和对照组（88例）。两组患者均根据临床诊断给予常规治疗，在此基础上，临床药师全程参与干预组的抗感染治疗，包括参与药学查房、制订抗感染方案、指导护士落实抗感染方案、为患者提供药学监护等。评价两组患者有效性、安全性和抗菌药物临床应用指标（如重点监控药品使用比例、疗程、费用等）。结果：干预组患者治愈率（98.91％）显著高于对照组（93.18％），不良反应发生率（8.70％）显著低于对照组（23.86％）；抗菌药物使用种类更加合理（如干预组和对照组患者碳青霉烯类使用比例分别为20.65％、36.36％，喹诺酮类使用比例分别为15.22％、28.41％）；干预组患者抗菌药物使用时间（[15.18±2.25）d]显著短于对照组（[19.84±3.81）d]，人均抗菌药物费用（[2846.99±712.48）元]显著低于对照组（[3991.26±577.82）元]，以上差异均有统计学意义（P＜0.05或P＜0.01）。结论：临床药师全程参与ICU感染性休克患者的抗感染治疗，为患者提供药学服务，可提高抗感染疗效，减少药品不良反应及药源性疾病的发生，优化抗菌药物的应用指标及降低医疗费用。 |
| ABSTRACT： | OBJECTIVE：To explore the role of clinical pharm acists in anti-infective therapy in patients with septic shock in the ICU. METHODS ：A total of 180 patients with septic shock were retrospectively collected from ICU of Chongqing Qianjiang Central Hospital during Jan.-Dec. 2018. According to whether clinical pharmacists participated in anti-infective therapy in the whole process，the patients were divided into intervention group （92 cases）and control group （88 cases）. Both groups were given routine treatment according to clinical diagnosis ；on this basis ，clinical pharmacists participated in the whole anti-infective therapy of the intervention group ，including participating in pharmaceutical rounds ，formulating anti-infective programs ，guiding nurses to implement anti-infective plan ，and providing pharmaceutical care for patients. The effectiveness ，safety and antibiotics clinical use indexes（such as proportion ，treatment course and cost of key monitored drugs ）were evaluated in 2 groups. RESULTS ：The cure rate of intervention group （98.91％）was significantly higher than that of control group （93.18％），while the incidence of ADR in the intervention group （8.70％）was significantly lower than control group （23.86％）. The use of antibiotics types was more rational（the proportion of carbapenems used in intervention group and control group were 20.65％，36.36％；those of quinolones were 15.22％，28.41％，respectively）；the duration of antibiotics use in the intervention group [ （15.18±2.25）d] was significantly shorter than control group [ （19.84±3.81）d]. The cost of antibiotics per capita [ （2 846.99±712.48）yuan] was significantly lower than control group [ （3 991.26±577.82）yuan]，with statistical significance of all above （P＜0.05 or P＜0.01）. CONCLUSIONS ： Clinical pharmacists participating in the anti-infective treatment of ICU patients with septic shock and providing pharmaceutical care，can improve the anti-infective effect ，reduce adverse drug reactions and drug-induced diseases ，optimize the use of antibiotics and reduce medical cost. |
| 期刊： | 2020年第31卷第11期 |
| 作者： | 廖玉芳，李飞，闫建华，司可 |
| AUTHORS： | LIAO Yufang ，LI Fei，YAN Jianhua ，SI Ke |
| 关键字： | 临床药师；重症加强护理病房；感染性休克；抗感染；药学服务 |
| KEYWORDS： | Clinical pharmacist ；ICU；Septic shock ；Anti-infection；Pharmaceutical care |
| 阅读数： | 532 次 |
| 本月下载数： | 22 次 |
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