| 摘要: |
| 目的：通过对23例儿童泌尿系统感染临床药师会诊结果的分析，为专科临床药师会诊提供指导依据，为评估药师与临床学科间的合作模式提供参考。方法：统计分析我院儿科临床药师在2013年9月至2014年2月为23例儿童泌尿外科抗细菌感染治疗的25份会诊建议及相关病历资料，根据是否有明确尿培养感染致病菌及感染程度分为A（尿细菌培养阳性）、B（无尿培养结果但感染明确）、C（有明确的泌尿系统感染高危因素）三组，对三组患儿抗菌治疗方案的调整、医师的接受程度及患儿调整后的转归情况进行分析。结果：A组与B组的尿常规白细胞计数平均值分别为11.86/HP和14.30/HP，差异无统计学意义；三组患儿在发热、外周血白细胞计数和C反应蛋白、泌尿系统感染阳性症状的发生例数方面比较差异无统计学意义；感染致病菌以G-菌为主，占72.7%；药师会诊提供的具有明确目标致病菌的治疗方案调整率及医师对会诊的接受率均达100%；临床药师会诊后，经更换或调整患儿的抗菌治疗方案，患儿均全部治愈。结论：临床药师在泌尿系统感染患儿的药学监护中，对缺乏尿路感染主要证据的患儿，可以根据尿路感染其他相关指标综合评估患儿病情，做到对目标致病菌的有效抗感染治疗，而特定抗菌谱的选择、足疗程的抗感染治疗是成功的关键。临床药师在药物应用的专业性方面受到临床医师的认可。 |
| 关键词: 泌尿系统感染 目标致病菌 会诊 临床药师 儿童 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2016.04.013 |
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| 基金项目:上海市高校优秀青年教师选拔科技基金专项，编号jdy10124。 |
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| Analysis of Consultations Supplied by Clinical Pharmacist for 23 Children with Urinary Tract Infection |
| Zhang Chun, Fang Xiaoliang, Li Fang, Bo Shuhong, Lu Xiaotong, Zhang Jian |
| (Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China) |
| Abstract: |
| Objective: Through the 23 cases analysis of the clinical pharmacists consultation results urinary tract infections in children, provide guiding basis for specialized clinical pharmacists consultation, to assess the pharmacist and the clinical disciplines cooperation mode to provide the reference. Methods: 25 cases of consultation about antibiotic treatment for urinary tract infection and related patients’clinical information during September in 2013 to February in 2014 were analyzed. According to whether there is A clear urine culture infection pathogens and infection degree is divided into A (urine bacteria culture positive), B (not clear urine culture results but infection), C (there is a clear urinary tract infection risk factors) three groups, the adjustment of three groups of children with antibacterial treatment, physicians acceptance and children after adjusting the outcome of analysis. Results: The mean counts of leukocyte under each high power hens of microscopeare 11.86 in the group of positive cultured bacteria and 14.3 in the group of no cultured results. There isno obvious difference in the number of leukocyte under each high power hens of microscope. There is no obvious difference between the two groups in the incidence rate of feverish children, obviously raise of number of white blood cell, C reaction protein and related urinary infection symptoms. The majority infection bacteria were Gram negative bacteria in the group of culture positive of urine, which accounted for 72.7%. Both the modulation rate and the acceptance rate by doctors of consultations with specific cultured bacteria were the highest to 100%. After consultation, the treatment was adjusted, and the outcome of all patient children were evaluate with cured. Conclusion: The evidence of pharmacists in the absence of a urinary tract infection, can according to the children with urinary tract infection related index comprehensive evaluation, do effective anti-infection treatment of target pathogens. Clinical pharmacists in pharmaceutical care of children with urinary system infection, choose the specific antimicrobial spectrum, foot treatment course of anti-infection treatment is the key to success. The professional antibiotics application applied by clinic pharmacist are deeplyorganized and accepted by doctors. |
| Key words: urinary tract infection target pathogenic bacteria consultation clinical pharmacist children |
