目的：探讨临床药师在临床实践中实施动态药学监护的模式与方法。方法：回顾分析临床药师参与1例慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭患者的动态药学监护，从抗感染、解痉平喘、扩血管改善微循环、祛痰等对症治疗方面，结合临床变化，动态分析药物治疗情况，提供建设性的治疗建议，协助医师制订最佳的治疗方案。结果：临床药师的建议大多被采纳，患者咳嗽、胸闷、气促、Ⅱ型呼吸衰竭等较前明显好转。结论：临床药师对整个临床治疗过程进行的动态药学监护，提高了药物治疗效果和患者生活质量，并避免了药品严重不良反应的发生。%OBJECTIVE:To explore the mode and method of dynamic pharmaceutical care carried out by clinical pharmacist in clinical practice.METHODS:A retrospective analysis was performed on clinical pharmacist’ practice of dynamic pharmaceutical care provided for one case of acute exacerbation of chronic obstructive pulmonary disease complicated by type Ⅱ respiratory failure.The clinical pharmacist gave dynamic analysis on medications including anti-infective, antispasmodic, antiasthmatic, vasodilative to improve microcirculation and phlegm expelling medications and other symptomatic treatment based on patient ’ clinical change and cooperate with physicians in making optimal therapeutic regimen by offering constructive recommendations on treatment.RESULTS:Most of clinical pharmacist’ s recommendations have been adopted, patients’ symptoms such as cough, chest tightness and shortness of breath and type Ⅱrespiratory failure improved markedly.CONCLUSIONS: Dynamic pharmaceutical care carried out by clinical pharmacist during the entire clinical treatment process resulted in improvement of therapeutic efficacy and patients’ quality of life meanwhile avoiding the occurrence of serious adverse drug reactions.
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