| 摘要: |
| 目的:总结临床药师参与小儿外科抗感染会诊的病例特点,评价干预效果,并探讨适用于该专科的服务模式。方法:回
顾性分析2024 年9 月至2025 年2 月我院临床药师参与的60 例小儿外科感染患儿(累计会诊69 次) 的临床资料,总结会诊目
的、会诊建议、会诊采纳率及治疗效果。结果:患儿以腹腔感染为主71. 7%(43/ 60)。30 例患儿检出病原菌50 株,其中革兰阴
性菌占54. 0%(27/ 50),主要为大肠埃希菌与肺炎克雷伯菌。申请药师会诊主要理由为原方案疗效不佳(49. 3%) 与培养阳性
需目标治疗(43. 5%)。会诊意见总采纳百分比为92. 8%(64/ 69),临床药师参与会诊的治疗总有效率达90. 0%(54/ 60)。会诊
后患儿体温、白细胞计数(WBC)、C 反应蛋白(CRP)、降钙素原(PCT)等恢复正常时间中位数分别为2. 5、6. 0、6. 0、7. 0 d,抗菌
药物疗程中位数为7. 0 d。会诊前后患儿WBC、中性粒细胞计数(NEU)、淋巴细胞计数(LYM)、血小板计数(PLT)及CRP 等比
较,差异均有统计学意义(P<0. 05)。结论:临床药师参与小儿外科抗感染会诊能有效提升治疗效果,是优化抗菌药物管理的关
键举措。基于实践提炼的“四步法”工作模型,为规范小儿外科抗感染药学服务提供直接、可行的实践参考。 |
| 关键词: 临床药师 小儿外科 抗感染会诊 抗菌药物管理 药学服务模式 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2026.10.008 |
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| 基金项目:河南省科学技术厅科技发展计划项目,编号252102310228;南阳市科技攻关项目,编号24KJGG178 |
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| Review of Anti-Infection Consultation in Pediatric Surgery by Clinical Pharmacists and Exploration of Pharmaceutical Service |
| Zhang Yu, Gu Yuhan, Zheng Zhixin, Yao Dandan |
| ((Nanyang Central Hospital, Henan Nanyang 473000, China)) |
| Abstract: |
| Objective: To summarize the case characteristics of clinical pharmacists’ participation in anti-infection consultation in
pediatric surgery, evaluate the intervention effect, and explore the suitable service model. Methods: Retrospective analysis was
conducted on clinical data of 60 pediatric surgical infection patients (with a total of 69 consultations) who were involved in by clinical
pharmacists in our hospital from Sept. 2024 to Feb. 2025. The purpose, suggestion, adoption rate and therapeutic effect of consultation
were summarized. Results: The majority of the patients (71. 7%, 43/ 60) had abdominal cavity infections. Fifty strains of pathogenic
bacteria were found in 30 patients, including 27 strains of aerobic Gram-negative bacteria (54. 0%). The primary pathogens were
Escherichia coli and Klebsiella pneumoniae. The main reasons for requesting a pharmacist consultation were that the original treatment
regimen was ineffective (49. 3%) and the culture test was positive and required targeted treatment (43. 5%). About 92. 8% (64/ 69) of
the consultation opinions were accepted, and the total effective rate of the treatment with the participation of clinical pharmacists in the
consultation reached 90. 0 % (54/ 60). After consultation, the median time for the infection indicators such as body temperature, white
blood cell (WBC), C-reactive protein (CRP) and platelet count (PCT) to return to normal state was 2. 5, 6. 0, 6. 0 and 7. 0 d
respectively. The median course of antibacterial drug treatment was 7. 0 d. There were statistically significant differences in WBC,
neutrophil (NEU), lymphocyte (LYM), platelet (PLT) and CRP levels between two groups before and after consultation (P<0. 05).
Conclusion: Clinical pharmacists’ participation in anti-infection consultation in pediatric surgery can effectively enhance the therapeutic
effect, which is a key measure to optimize the management of antimicrobial drugs. Furthermore, the Four-Step Practice Pattern developed
from this study provides a direct and feasible reference for standardizing pharmaceutical care in pediatric surgical anti-infection services. |
| Key words: clinical pharmacists pediatric surgery anti-infective consultation antimicrobial stewardship pharmaceutical service model |
