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目的探讨临床药师对特殊患者抗凝治疗的药学监护的内容和模式。方法通过一例术后肺栓塞患者抗凝药物调整过程,分析临床药师如何针对高危患者进行个体化药学监护。结果临床药师根据患者病情,进行了风险评估,参与拟定治疗方案,并针对治疗过程中出现的INR值升高及时调整用药方案,使患者抗凝治疗安全达标,住院期间未出现出血及血栓事件。结论临床药师积极开展药学监护,使患者达到了满意的抗凝治疗效果,避免药物不良反应的发生,保障了药物使用的有效性和安全性。
Objective To explore the contents and patterns of pharmacological nursing for clinical patients on anticoagulant therapy in special patients. Methods A case of postoperative pulmonary embolism in patients with anticoagulant adjustment process, analysis of how the clinical pharmacists for high-risk patients for individualized pharmacy care. Results According to the patient’s condition, the clinical pharmacists conducted risk assessment and participated in the formulation of the treatment plan. In response to the rising INR value in the course of treatment, the medication regimen was adjusted in time so as to ensure the patient’s anticoagulant therapy to reach the standard and no bleeding and thrombosis during the hospitalization. Conclusion Clinical pharmacists actively carry out pharmacy care, so that patients achieve satisfactory anticoagulant therapy to avoid the occurrence of adverse drug reactions, to ensure the effectiveness and safety of drug use.