天津医药

天津医药 ›› 2019, Vol. 47 ›› Issue (3): 281-283.doi: 10.11958/20181797

• 临床研究 • 上一篇    下一篇

慢性肾病患者行连续性肾脏替代治疗时抗菌药物治疗方案调整的分析与思考

白靖，刘江，侯娟，韩雅琦，张坤，陈欣然，胡振杰   

  1. 1河北医科大学第四医院药学部（邮编050011），2重症医学科
  • 收稿日期:2018-11-19 修回日期:2019-01-16 出版日期:2019-03-15 发布日期:2019-04-24
  • 通讯作者: 胡振杰 E-mail:syicu@vip.sina.com

Analysis and reflection on the dose-adjustment of antibiotics for patients with chronic kidney disease in continuous renal replacement therapy

BAI Jing,LIU Jiang,HOU Juan,HAN Ya-qi,ZHANG Kun,CHEN Xin-ran,HU Zhen-jie   

  1. 1 Department of Pharmacy, 2 Department of ICU, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
  • Received:2018-11-19 Revised:2019-01-16 Published:2019-03-15 Online:2019-04-24

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摘要： 危重患者行连续性肾脏替代治疗（CRRT）时，受CRRT模式、药物特性及患者病生理状态等因素的影响，抗菌药物的药代动力学和药效动力学参数改变，进而影响抗菌药物给药方案的调整。本文就1例行CRRT治疗的慢性肾病患者应用万古霉素的病例进行分析，探讨CRRT时抗菌药物剂量调整的影响因素。提供个体化给药方案，保证了患者抗感染治疗的安全性和有效性。

关键词: 肾病, 血液滤过, 万古霉素, 剂量调整, 连续性肾脏替代治疗

Abstract: When continuous renal replacement therapy (CRRT) is performed in critically ill patients, the pharmacokinetics and pharmacodynamic parameters of antibiotics are affected by some factors, such as CRRT, drug properties and pathophysiological condition of patients, which can in turn affect the administration of antibiotics. This article analyzed the dose adjustment of vancomycin in a patient with chronic renal disease treated with CRRT, and discussed the influencing factors of antibacterial dose adjustment in CRRT. Individualized drug administration can ensure the safety and effectiveness of anti - infective therapy.

Key words: nephrosis, hemofiltration, vancomycin, dose adjustment, continuous renal replacement therapy