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目的:为肾移植术后肺部感染患者实施药学监护提供思路。方法:临床药师全程参与1例肾移植术后并发肺部感染患者的诊疗经过,通过查阅文献,结合患者病情,充分考虑患者病史、临床症状和实验室检查,对该患者药物治疗过程进行分析,并总结其治疗过程中的药学监护重点。结果:对该例肾移植术后肺部感染患者监护重点包括发病早期和病情好转时免疫抑制药剂量调整;多种抗感染药物与免疫抑制药合用时的药物相互作用;根据患者肾功能对患者用药剂量进行调整;药物不良反应监测等方面,为患者制定个体化用药方案。结论:临床药师通过全面的药学监护,能协助医师及时、有效地制定用药方案,为患者提供专业、有效的药学服务。
Objective: To provide ideas for the implementation of pharmacy care in patients with pulmonary infection after renal transplantation. Methods: Clinical pharmacists were involved in the diagnosis and treatment of 1 case of pulmonary infection after renal transplantation. Through the literature review, combined with the patient’s condition, taking full account of the patient’s medical history, clinical symptoms and laboratory tests, analysis of the drug treatment process, And summarize the focus of their pharmacy care during their treatment. Results: In this case, the monitoring of patients with pulmonary infection after renal transplantation focus on the early onset and improvement of immune suppression when the dose adjustment; a variety of anti-infectives and immunosuppressive drugs in combination with the drug interaction; according to patients with renal function in patients Medication dose adjustment; adverse drug reactions monitoring, etc., for patients to develop individualized drug program. Conclusion: Through comprehensive pharmacy monitoring, clinical pharmacists can assist physicians to formulate timely and effective medication plans and provide professional and effective pharmacy services to patients.