对1例放射性肠炎合并真菌感染患者的药学监护

1例54a女性患者,因子宫内膜癌术后放疗50d,间断腹泻40d加重1d入院。入院后给予止泻、抗感染、纠正电解质失衡等对症治疗。临床药师参与了抗菌药物选择及抗真菌药物剂量调整、非甾体抗炎药物的优化使用、血必净注射液不良反应的评估等药学监护内容。建议将非甾体抗炎药物吲哚美辛胶囊换为栓剂以避免加重肠黏膜损伤;抗真菌药物应保证足够的剂量和疗程以达到疗效;血必净注射液因有活血化瘀作用,对肠道黏膜损伤患者应关注其致出血的不良反应。

Pharmaceutical care on a radiation enterocolitis patient with fungous infection

A 54-year-old female patient,who recieved postoperation radiotherapy for endometrial cancer 50 days ago,had suffered from intermittent coprorrhea for 40 days and symptom aggravation for one day,was hospitalized for further treatment.After admission,symptomatic treatments,such as checking diarrhea,anti-infection,rectification of electrolyte imbalance,were given.Pharmaceutical cares were given to the patient,which included the selection of anti-infection agent,dose adjustment of antifungal agent,optimizing the use of nonsteroidal anti-inflammatory drugs（NSAIDs）,and evaluating the adverse reaction induced by Xuebijing injection.Clinical pharmacists suggested adjusting indomethacin capsule to indomethacin suppository for avoiding the impairment of intestinal mucosa.The adequate dosage and course duration of antifungal agents should be ensured.In the patient with impairment of intestinal mucosa,hemorrhage induced by Xuebijing injection should be paid more attention to.