Pharmaceutical service in a case of fat embolism syndrome following postoperative fracture

ZHANG Leijiao; WANG Pingping; YAN Qinqin; HUANG Haiyu; HUANG Guoxi; WU Xue

doi:10.6039/j.issn.1001-0408.2024.22.20

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Pharmaceutical service in a case of fat embolism syndrome following postoperative fracture

更新时间：2024-11-26

- Pharmaceutical service in a case of fat embolism syndrome following postoperative fracture
- ZHONGGUO YAOFANG Vol. 35, Issue 22, Pages: 2822-2827(2024)
- 作者机构：
  
  中国人民解放军联勤保障部队第九二四医院药剂科，广西桂林　541002
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2024.22.20
  CLC： R969.3;R977.1
- Published：30 November 2024，
  
  Received：06 June 2024，
  
  Revised：15 October 2024，
- 稿件说明：
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张磊姣,王平平,闫琴琴等.1例骨折术后并发脂肪栓塞综合征的药学服务 ^Δ[J].中国药房,2024,35(22):2822-2827.

ZHANG Leijiao,WANG Pingping,YAN Qinqin,et al.Pharmaceutical service in a case of fat embolism syndrome following postoperative fracture[J].ZHONGGUO YAOFANG,2024,35(22):2822-2827.
张磊姣,王平平,闫琴琴等.1例骨折术后并发脂肪栓塞综合征的药学服务 ^Δ[J].中国药房,2024,35(22):2822-2827. DOI： 10.6039/j.issn.1001-0408.2024.22.20.

ZHANG Leijiao,WANG Pingping,YAN Qinqin,et al.Pharmaceutical service in a case of fat embolism syndrome following postoperative fracture[J].ZHONGGUO YAOFANG,2024,35(22):2822-2827. DOI： 10.6039/j.issn.1001-0408.2024.22.20.

摘要

目的

分析1例骨折术后并发脂肪栓塞综合征（FES）患者的药学服务过程，为类似患者的临床治疗和药学服务提供参考。

方法

临床药师参与1例骨折术后并发FES患者治疗的全过程，根据患者的临床表现、检验结果等情况，查阅文献，协助临床医师制定糖皮质激素的用药方案；针对患者治疗过程中出现的肾功能损害、血小板计数减少的药品不良反应，分析可疑药物并进行处置。

结果

临床药师建议使用注射用氢化可的松琥珀酸钠（100 mg，q8 h，ivgtt，连续使用约1周后逐渐减少剂量）治疗FES。该病例使用的注射用盐酸万古霉素与肾功能损害、血小板计数减少的药品不良反应关联性评价为“很可能”。临床医师采纳药师的用药建议，患者经过治疗后病情稳定，不良反应好转后出院。

结论

糖皮质激素治疗FES有明确疗效，临床药师应根据患者的病理状态个体化制定用药方案，并注意与术后脓毒血症加以区分，同时需要密切关注药物引起的肾脏、血液系统等不良反应。

Abstract

OBJECTIVE

To analyze the pharmaceutical service process in a fracture patient complicated by fat embolism syndrome （FES） following postoperative fracture， aiming to provide a reference for clinical treatment and pharmaceutical service for similar patients.

METHODS

Clinical pharmacist participated in the entire treatment process of a patient with FES following postoperative fracture. Based on the patient’s clinical manifestations and test results， literature was reviewed to assist clinical physicians in formulating the therapeutic regimen of glucocorticoids. For the drug-related adverse reactions of renal function impairment and reduced platelet count that occurred during the treatment， suspicious drugs were analyzed and disposed of accordingly.

RESULTS

The clinical pharmacist recommended Hydrocortisone sodium succinate for injection （100 mg， q8 h， ivgtt， for about one week followed by a gradual dose reduction） for treating FES. The Vancomycin hydrochloride for injection used in this case was assessed as “very probably” associated with the adverse drug reactions of renal function impairment and thrombocytopenia. The clinical physician adopted the pharmacist’s medication recommendations， and the patient’s condition stabilized after treatment， with improvement in adverse reactions， and was discharged from the hospital.

CONCLUSIONS

The use of glucocorticoids in treating FES has a definite therapeutic efficacy. Clinical pharmacists should individualize the medication plan based on the patient’s pathological state and distinguish it from postoperative sepsis. Meanwhile， drug-induced adverse reactions in the kidney and blood system should be closely monitored.

关键词

脂肪栓塞综合征药学服务骨折术后糖皮质激素肾功能损害血小板减少

Keywords

pharmaceutical servicepostoperative fractureglucocorticoidsrenal function impairmentthrombocytopenia

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