临床药师参与1例肺毛霉菌感染患者诊治并文献分析

目的 探讨临床药师在糖尿病酮症酸中毒合并肺毛霉菌感染患者临床治疗实践中的作用。方法 临床药师参与1例糖尿病酮症酸中毒并肺毛霉病感染患者的治疗过程，从问诊病史、危险因素分析、药物品种选择、给药方式、给药剂量、不良反应监护和用药教育等方面进行药学服务。结果 根据患者的年龄、经济条件、肾功能、耐受性个体化给予两性霉素B 25 mg qd静滴和5 mg雾化吸入bid治疗。用药过程中监测肾功能、电解质K⁺水平并进行相应处理。患者病情好转，未发生严重不良反应，生命体征平稳出院。结论 临床药师协助医师为肺毛霉菌感染患者制定安全、有效的治疗方案并进行药学监护，可预防不良反应发生、促进临床合理用药。

Clinical Pharmacists Participating in Diagnosis and Treatment of One Case of Pulmonary Mucormycosis Infection and Literature Analysis

OBJECTIVE To explore the role of clinical pharmacists played in the clinical practice of patients with diabetic ketoacidosis and pulmonary mucormycosis infection. METHODS Clinical pharmacists participated in the treatment progress for one case of diabetic ketoacidosis complicated with pulmonary mucormycosis infection, provided pharmaceutical care in terms of medical history, risk factors analysis, drug selection, mode of administration, dosage, adverse reaction monitoring and medication education. RESULTS Amphotericin B 25 mg intravenous drip qd and 5 mg aerosol inhalation bid were given individually according to patient''s age, economic condition, renal function and tolerance. The levels of renal function and electrolyte K⁺ were monitored and processed accordingly. The patient''s condition improved with no serious adverse reactions, and the vital signs were stable and discharged. CONCLUSION Clinical pharmacists can assist physicians to formulate safe and effective treatment for pulmonary mucormycosis patients, carry out pharmaceutical care, prevent adverse reactions, and promote clinical rational drug use.