目的:探索临床药师参与临床实践的模式.方法:就临床药师对1例后颅窝术后颅内感染患者治疗方案的调整及围术期感染的危险因素进行总结分析,依据颅内感染和我院细菌耐药情况,结合抗菌药物的抗菌谱、药动学特征,调整治疗方案并进行药学监护.同时进行文献分析,总结颅脑手术围术期感染的危险因素,提出预防建议.结果:调整治疗方案后,患者的脑脊液实验室检查指标明显改善,取得良好的治疗效果.结论:解决临床问题是临床药师参考临床实践的有效切入点.%OBJECTIVE: To explore the mode of clinical pharmacist participating in clinical practice. METHODS: The adjustment of treatment scheme for a patient with postoperative intracranial infection and risk factor of perioperative infection were summarized and analyzed. According to intracranial infection and bacterial resistance to antibiotics of our hospital, and antibacterial spectrum and pharmacokinetic characteristics of antibacterial drugs, we adjusted treatment scheme and provided pharmaceutical monitoring. By reviewing literature and summarizing risk factors of postoperative intracranial infection, we provided prevention advice. RESULTS: The laboratory parameters of cerebrospinal fluid were significantly improved after adjustment, and we achieved a good result. CONCLUSION: It is effective route for clinical pharmacist entering clinical practice to solve clinical problems.
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