临床药师参与1例术后血小板减少重症患者CRRT抗凝方案制定

摘 要 目的： 探讨临床药师为重症患者制定个体化连续性肾脏替代治疗（CRRT ）抗凝方案的思路与方法。方法: 临床药师参与1例主动脉夹层术后血小板减少重症患者CRRT的抗凝治疗方案的制定过程，分析患者血小板减少的原因及凝血功能，排除由肝素诱导血小板减少的因素，制定了在补充血小板前提下以局部枸橼酸抗凝的CRRT抗凝方式。结果: 患者CRRT顺利进行，CRRT治疗3天后，患者肾功能恢复正常，转至普通病房。结论:临床药师深入临床，为患者制定个体化的用药方案，保证了治疗效果及用药安全性。

Participation of Clinical Pharmacists in One Case of Severe Thrombocytopenia after Operation Treated with CRRT Anticoagulation

ABSTRACT Objective: To investigate the thoughts and the methods of clinical pharmacists in the individual continuous renal replacement therapy (CRRT) anticoagulation treatment for severe patients.Methods: Clinical pharmacists participated in the CRRT anticoagulation treatment for one patient with severe thrombocytopenia after aortic dissection surgery. Clinical pharmacists analyzed the causes of thrombocytopenia and the coagulation function of the patient to exclude heparin induced thrombocytopenia, and developed the treatment of supplementing platelets and regional citrate anticoagulation as the way of CRRT. Results: Three days after the treatment, the patient was changed to the general ward with normal renal function. Conclusion:Clinical pharmacists should participate in clinical treatment comprehensively and perform individual treatment for patients in order to ensure the effect and safety of medication.