摘要
目的 提高行活体肝移植患儿治疗的有效性和安全性。方法 收集医院2017年7月至2023年12月接受活体肝移植患儿的多学科联合会诊(MDT)病历资料,提取并分析患儿的基本资料、围术期抗感染药物使用情况、病原学检查结果,临床药师参与MDT的目的及会诊建议采纳情况,以及患儿转归情况等。结果 共收集患儿137例,开展MDT 154例次,其中临床药师参与141例次;患儿年龄以> 6个月至1岁居多(68例次、32.85%),原发疾病主要为胆道闭锁(96例次、70.07%);器官移植科(154例次、100.00%),儿科(147例次、95.45%),儿童重症监护室(142例次、92.21%)参与患儿MDT较多;临床药师参与MDT的目的以指导选择/调整抗感染药物为主(112例次、79.43%),31例术后早期病原学检查结果为阳性,共检出54株病原菌,其中革兰阴性菌的检出率最高(31株、57.41%),抗感染药物主要为头孢哌酮舒巴坦(1∶1,68例、49.64%);临床药师意见的全采纳率为83.69%,其中痊愈率为42.37%。结论 临床药师参与MDT,可为接受活体肝移植患儿个体化用药提供专业的药学意见,从而进一步保障治疗的有效性和安全性。
Objective To improve the effectiveness and safety of pediatric living liver transplantation.Methods The medical records of children underwent the living liver transplantation and received multi-disciplinary treatment(MDT)in the hospital from July 2017 to December 2023 were collected.The children′s basic information,perioperative use of anti-infective drugs,pathogen examination,purpose of clinical pharmacists participating in MDT,adoption of consultation recommendations and children′s disease outcomes were extracted and analyzed.Results A total of 137 children were included,who underwent 154 case times of MDT,with clinical pharmacists participating in 141 case times.The children were mainly in the range of>six months to one year(68 case times,32.85%),and the main primary disease was biliary atresia(96 case times,70.07%).The staff in the organ transplantation department(154 case times,100.00%),pediatrics(147 case times,95.45%)and pediatric intensive care unit(142 case times,92.21%)participated more in pediatric MDT.The purpose of clinical pharmacists participating in MDT was mainly to guide the selection/adjustment of anti-infective drugs(112 case times,79.43%).The early postoperative pathogen examination in 31 children was positive,and 54 strains of pathogenic bacteria were detected,in which the detection rate of Gram-negative bacteria was the highest(31 strains,57.41%),and the main anti-infective drug was cefoperazone and sulbactam(1∶1,68 cases,49.64%).The overall adoption rate of clinical pharmacists′opinions was 83.69%,with a cure rate of 42.37%.Conclusion The clinical pharmacists′participation in MDT can provide professional pharmaceutical recommendations for individualized medication in children undergoing living liver transplantation and further ensure the effectiveness and safety of treatment.
作者
陈依雨
董淳强
马亮
林忠秋
黄振光
张宏亮
CHEN Yiyu;DONG Chunqiang;MA Liang;LIN Zhongqiu;HUANG Zhenguang;ZHANG Hongliang(The First Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi,China 530021;School of Basic Medical Sciences,Guangxi Medical University,Nanning,Guangxi,China 530021)
出处
《中国药业》
CAS
2024年第14期26-30,共5页
China Pharmaceuticals
基金
广西壮族自治区高校中青年教师科研基础能力提升项目[2023KY0119]
广西壮族自治区大学生创新训练项目[S202210598096]
广西医科大学第一附属医院临床研究攀登计划项目[YYZS2021005]。
关键词
活体肝移植
儿童
临床药师
多学科联合会诊
药学监护
living liver transplantation
child
clinical pharmacist
multi-disciplinary treatment
pharmaceutical care
