临床药师参与1例新生儿化脓性脑膜炎治疗的分析与体会

李迪  易燕桃  蓝海燕

[摘要]临床药师参与药物治疗方案的设计与实践，实施周全的药学监护，切切实实地参与临床治疗团队中去，对促进临床安全、有效、经济的药物治疗，降低风险等起着重要的作用。本文就本院临床药师参与1例新生儿化脓性脑膜炎病例诊疗过程，从患儿感染的原因、用药治疗和药学监护等多方面进行综合分析，探讨临床药师通过会诊参与临床治疗的方法和作用。临床药师对治疗用药过程中给出合理化用药方案，药学监护周全，均被医师采纳，取得良好的效果，值得临床借鉴。

[关键词] 临床药师；化脓性脑膜炎；药学监护

[中图分类号] R722.13   [文献标识码] B   [文章编号] 2095-0616（2014）09-169-03

Analysis and experience of clinical pharmacist involving in treatment for one case with neonatalpurulent meningitis

LI Di1  YI Yantao1  LAN Haiyan2

1.Department of Pharmacy, Zhaoqing Second People's Hospital, Zhaoqing 526060, China;2.Department of Neonatology, Zhaoqing Second People's Hospital, Zhaoqing 526060, China

[Abstract] Clinical pharmacists involved in drug therapy scheme design and practice, practice thoughtful pharmaceutical care, and truly involved in clinical treatment team, which showed important effect for promoting security, efficacious and economic drug therapy, and reducing risks. This study analyzed by sythesis for clinical pharmacist involving in treatment for one case with neonatalpurulent meningitis from multiaspects of the cause of the infection, medicate and pharmaceutical care and son, to discuss method and effect of clinical pharmacist involving in treatment by consultation. Cinical pharmacist provided rationalization of regimen in drug therapy with thoughtful pharmaceutical care, which were accepted by doctors, and achieved good results, worthy of clinical application. 

[Key words] Clinical pharmacist;Neonatalpurulent meningitis;Pharmaceutical care

化脓性脑膜炎（以下简称化脑）是小儿、尤其婴幼儿时期常见的中枢神经系统感染性疾病。年龄小于3个月的婴儿和新生儿化脑表现多不典型，其预后与治疗是否积极、有效密切相关，选择有效的抗菌药物是治疗的关键。笔者就参与1例新生儿化脓性脑膜炎病例的诊疗过程，现对其进行分析和讨论。

1 病例介绍

患儿，女，于2013年02月28日22时20分在我院产科足月顺产出生，出生时羊水清，脐带无绕颈，出生体重4.17kg，分娩过程中胎肩娩出困难。患儿生后正常开奶，吮奶一般；39min前产科护士巡房时发现患儿颜面发绀，即抱患儿至产房吸氧、保暖抢救治疗，33min前患儿突然呕吐鲜红色胃内容物1次（量约10mL），伴有四肢肢端发绀、呻吟样呼吸，即予清理呼吸道、吸氧救治，为进一步诊治，拟“呕血查因”收住新生儿科治疗。……