中国医院用药评价与分析
中國醫院用藥評價與分析
중국의원용약평개여분석
EVALUATION AND ANAL YSIS OF DRUG-USE IN HOSPITALS OF CHINA
2014年
12期
1135-1137,1138
,共4页
化疗%骨髓抑制%分析%临床药师%用药教育
化療%骨髓抑製%分析%臨床藥師%用藥教育
화료%골수억제%분석%림상약사%용약교육
Chemotherapy%Myelosuppression%Analysis%Clinical pharmacist%Medication education
目的：探讨顺铂＋氟尿嘧啶联合治疗食管癌后出现Ⅳ度骨髓抑制的原因，以减少肿瘤患者化疗后出现骨髓抑制的风险，提高患者预后及生存时间。方法：针对1例典型病例，依据食管癌相关诊疗规范和指南进行分析，评价顺铂＋氟尿嘧啶治疗的方案是否合理、化疗药的剂量是否适宜、对患者化疗相关性不良反应的监护是否密切、对化疗相关性不良反应的处置是否及时、有效，以及化疗药与骨髓抑制的关系等。结果：经临床药师分析，该例患者使用顺铂＋氟尿嘧啶治疗的方案合理，但氟尿嘧啶剂量偏小；顺铂和氟尿嘧啶均有导致骨髓抑制的风险，医务人员没有严密监护患者化疗后相关血液学指标，在患者及家属要求出院时，没有明确患者的相关身体指标是否适合出院。结论：作为肿瘤科临床药师，应协助临床医师监护患者化疗过程的安全性。尤其是首次化疗的患者，应对其进行用药教育，告知可能的化疗风险，避免患者在出现不适症状时产生恐慌。如有异常，应及时提示临床医师进行干预，尽可能降低化疗风险。
目的：探討順鉑＋氟尿嘧啶聯閤治療食管癌後齣現Ⅳ度骨髓抑製的原因，以減少腫瘤患者化療後齣現骨髓抑製的風險，提高患者預後及生存時間。方法：針對1例典型病例，依據食管癌相關診療規範和指南進行分析，評價順鉑＋氟尿嘧啶治療的方案是否閤理、化療藥的劑量是否適宜、對患者化療相關性不良反應的鑑護是否密切、對化療相關性不良反應的處置是否及時、有效，以及化療藥與骨髓抑製的關繫等。結果：經臨床藥師分析，該例患者使用順鉑＋氟尿嘧啶治療的方案閤理，但氟尿嘧啶劑量偏小；順鉑和氟尿嘧啶均有導緻骨髓抑製的風險，醫務人員沒有嚴密鑑護患者化療後相關血液學指標，在患者及傢屬要求齣院時，沒有明確患者的相關身體指標是否適閤齣院。結論：作為腫瘤科臨床藥師，應協助臨床醫師鑑護患者化療過程的安全性。尤其是首次化療的患者，應對其進行用藥教育，告知可能的化療風險，避免患者在齣現不適癥狀時產生恐慌。如有異常，應及時提示臨床醫師進行榦預，儘可能降低化療風險。
목적：탐토순박＋불뇨밀정연합치료식관암후출현Ⅳ도골수억제적원인，이감소종류환자화료후출현골수억제적풍험，제고환자예후급생존시간。방법：침대1례전형병례，의거식관암상관진료규범화지남진행분석，평개순박＋불뇨밀정치료적방안시부합리、화료약적제량시부괄의、대환자화료상관성불량반응적감호시부밀절、대화료상관성불량반응적처치시부급시、유효，이급화료약여골수억제적관계등。결과：경림상약사분석，해례환자사용순박＋불뇨밀정치료적방안합리，단불뇨밀정제량편소；순박화불뇨밀정균유도치골수억제적풍험，의무인원몰유엄밀감호환자화료후상관혈액학지표，재환자급가속요구출원시，몰유명학환자적상관신체지표시부괄합출원。결론：작위종류과림상약사，응협조림상의사감호환자화료과정적안전성。우기시수차화료적환자，응대기진행용약교육，고지가능적화료풍험，피면환자재출현불괄증상시산생공황。여유이상，응급시제시림상의사진행간예，진가능강저화료풍험。
OBJECTIVE:To probe into the causes of myelosuppression (Ⅳ degree ) in one case of esophageal cancer after treatment with cisplatin plus fluorouracil so as to reduce the risk of bone marrow in tumor patients after undergoing chemotherapy and improve tumor patients? prognosis and survival time. METHODS: Based on the related standard and guideline about the diagnosis and treatment of esophagus cancer, we evaluated whether the therapeutic regimen of cisplatin plus fluorouracil and the dosage of the chemotherapeutic drugs were rational, whether medical staff gave close attention to patients? chemotherapy?related adverse reactions, gave timely and effective management on the chemotherapy?related adverse drug reactions and the relation between chemotherapeutic drugs and myelosuppression. RESULTS:The therapeutic regimen cisplatin plus fluorouracil was rational but the dose of fluorouracil was on the lower side;both cisplatin and fluorouracil have the risk of causing bone marrow depression; medical staff did not pay close monitoring on patient?s chemotherapy?related hematological indices, nor did they define whether patient?s relative physical indicators are suitable for discharge when the patients and their family members had requirement for discharge from hospital. CONCLUSIONS:As a clinical pharmacist in the department of oncology, he should assist clinicians to monitor patients? safety throughout chemotherapy; for patients undergoing chemotherapy for the first time, clinical pharmacist provide them with medication education and let them know the potential risk of chemotherapy so as to avoid panic in case of adverse reactions. Furthermore, pharmacist should remind clinician to adopt intervention in case of abnormality so as to minimize the chemotherapy?related risks.
