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目的:分享医药协作救治鼠药中毒1例的临床实践经验。方法:医生早期识别诊断以意识障碍、凝血功能异常为表现的抗凝血杀鼠药中毒1例。临床药师积极参与药物治疗方案,确定维生素K1注射液30 mg·d-1的治疗剂量并行有效性监测;建议行毒物分析,后在血标本中检测到溴敌隆718 ng·ml-1,根据溴敌隆半衰期较长的特点初步拟定维生素K1治疗疗程为2~3个月;告知患者密切随访,随访计划与最终疗程根据凝血指标恢复情况而定。结果:患者入院后,医生迅速修正诊断,临床药师积极参与药物治疗方案,医护协作下患者意识迅速恢复,3周后凝血指标恢复正常,从住院治疗转为门诊随访。结论:医药协作为鼠药中毒的早期、足量、长疗程维生素K1治疗制定了最佳方案。
OBJECTIVE: To share the experience of clinical practice in treating 1 case of rat poisoning by medical cooperation. Methods: One case of anticoagulant and rodenticide poisoning was diagnosed by early diagnosis and identification of physicians with disturbance of consciousness and coagulation dysfunction. Clinical pharmacists actively involved in drug treatment programs to determine the dose of Vitamin K1 injection dose of 30 mg · d-1 parallel monitoring of efficacy; recommended poison analysis, and after the detection of bromadiolone 718 ng · ml-1 in blood samples, according to Bromadiolone half-life characteristics of the initial proposed vitamin K1 treatment course of 2 to 3 months; to inform patients closely followed up, follow-up plan and the final course of treatment according to the recovery of coagulation index may be. Results: After the patient was admitted to the hospital, the doctor quickly corrected the diagnosis. The clinical pharmacists actively participated in the drug treatment program. The patients’ awareness recovered promptly after medical cooperation. The coagulation index returned to normal after 3 weeks and went from outpatient treatment to outpatient follow-up. Conclusion: The medical cooperation has formulated the best plan for the early, adequate and long-term treatment of vitamin K1 in rat poisoning.