摘要
目的:分析肝癌肝动脉化疗栓塞术(TACE)术后发热的原因、常见不合理用药原因,探究肝癌TACE术后的药学监护,以确保用药的安全。方法:收集2018年6月至2019年12月在河南中医药大学第一附属医院脾胃科住院进行TACE术45例,采用单因素分析、二项logistic回归分析TACE术后发热的原因,并分析、汇总常见不合理用药原因,探究肝癌介入术后的药学监护。结果:经二项logistic回归分析,患者术后发热除与癌细胞坏死有关外,还与术后肝细胞受损有一定的关系。围术期预防感染用药的不合理用药为选药不适宜、超疗程用药;止吐药的不合理用药为未按要求改为口服给药、超疗程用药;PPIs的不合理用药为超疗程用药;保肝药的不合理用药为超剂量用药。结论:肝癌TACE术后发热,除与癌细胞坏死有关外,与化疗药引起的肝细胞损伤也有一定关系,但不能反映是否存在感染;临床药师应针对常见的不合理用药原因加强医嘱审核和药学干预,同时对用药期间加强用药安全性的监护。
Objective:To analyze the causes of fever and irrational drug use after liver cancer TACE operation,to study on pharmaceutical care of patients with liver cancer after TACE operation in order to ensuring the safety of medication.Methods:To collect cases of 45 TACE surgery in the Department of Spleen and Gastroenterology,the First Affiliated Hospital of Henan University of TCM from June 2018 to December 2019.Then to analyze the causes of fever after TACE and summarize the common causes of irrational drug use in order to studying on pharmaceutical care of liver cancer TACE operation.Results:According to binomial logistic analysis,postoperative fever is related to cancer cell necrosis and liver cell damage.The irrational use of drugs for prevention of infection in perioperative period is irrational drug selection and over course of treatment;The irrational use of antiemetic drugs is not to change orally as required and to medicate beyond the course of treatment.The irrational use of PPIs is over course of treatment.The irrational use of hepatoprotective drugs is overdose.Conclusion:Hepatocellular carcinoma TACE postoperative fever,in addition to cancer cell necrosis,and chemotherapy-induced hepatocyte injury also has a certain relationship,but can not reflect the existence of infection;in order to ensure the safety of drug use,clinical pharmacists should strengthen the examination of medical orders and pharmaceutical intervention according to the common causes of irrational drug use;at the same time,strengthen the monitoring of drug safety during the medication.
作者
程月召
薛昀
CHENG Yuezhao;XUE Yun(Hebei Provincial Hospital of TCM,Shijiazhuang Hebei 050011,China;The First Affiliated Hospital of Henan University of TCM,Zhengzhou Henan 450000,China)
出处
《药品评价》
CAS
2021年第10期594-597,共4页
Drug Evaluation
