临床药师参与1例人工肝术后下肢深静脉血栓病例的临床实践

目的 通过临床药师参与1例人工肝术后下肢深静脉血栓病例的临床治疗实践，探讨临床药师在治疗中所起的作用。方法 临床药师通过查阅指南、专家共识、文献资料，分析人工肝术后下肢深静脉血栓形成的原因，预防措施以及参与制定个体化抗凝治疗方案、药学监护及用药教育。结果 临床医师与药师共同制定华法林抗凝治疗方案，临床药师对患者进行药学监护、用药教育，用药过程未发生不良反应，患者熟练掌握华法林治疗注意事项，依从性良好。结论 临床药师协助临床医师制定个体化的抗凝治疗方案，做好药学监护、用药教育，保障治疗的安全性、有效性。

Clinical Practice of Clinical Pharmacist Participating in a Case of Deep Venous Thrombosis of Lower Limb After Artificial Liver

ABSTRACT: OBJECTIVE To discuss the role of clinical pharmacist in the treatment of a case deep venous thrombosis of lower limb after artificial liver by clinical practice. METHODS Basde on guidelines, expert consensus and literatures, clinical pharmacist analysis the causes of deep venous thrombosis of lower limb after artificial liver, preventive measures and participate in individualized anticoagulant therapy, pharmaceutical care and drug education. RESULTS The anticoagulant therapy of warfarin developed by clinician and clinical pharmacist cured the patient with no adverse drug reactions occurred ,and clinical pharmacist carry out pharmaceutical care, medication education. The patient master notice of warfarin and have good medication compliance. CONCLUSION Clinical pharmacist assist clinician to develop individualized anticoagulant therapy, carry out pharmaceutical care, medication education to ensure the safety and effectiveness of treatment.