1例突發性耳聾伴糖尿病、高血壓患者的診療及藥學監護分析

何嵐 彭江秋

[摘要]臨床藥師通過參與糖尿病的內科治療，對1例突發性耳聾伴糖尿病、高血壓患者糖皮質激素、調節血糖、血脂、血壓改善微循環及后續對癥治療藥物進行用藥分析，針對患者病情制定和實施個體化的藥學監護，同時根據藥物的臨床療效及時調整藥學監護方案。臨床藥師以糖皮質激素和血糖調節藥物為切入點，開展對患者全程的藥學監護，并及時發現、解決藥物治療中出現的問題。保證患者用藥合理、安全、有效，提高臨床治愈率。臨床藥師在臨床藥物治療實踐中累積了突發性耳聾伴糖尿病、高血壓患者治療突發性耳聾、調節血糖、血壓等藥物之間的相互作用的藥學監護經驗。臨床藥師參與臨床服務工作，應時刻“以患者為中心”，開展個體化用藥方案的設計及用藥監護，提供用藥教育等藥學服務。給予患者藥學服務，不但可以給予醫生和患者藥物治療上的藥學專業幫助，更可以穩定患者的治療情緒，增強患者信心，使患者滿意度增加，提高用藥依從性，體現臨床藥師價值。

[關鍵詞]突發性耳聾;糖尿病;高血壓;藥學監護

[中圖分類號] R473.76? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1674-4721（2019）2（c）-0187-03

[Abstract] By taking part in the medical treatment of diabetes， the clinical pharmacists analysiec the drug use of the glucocorticoid， regulating blood glucose， blood lipid， blood pressure， improving microcirculation and subsequent symptomatic treatment drugs in 1 cases of sudden deafness with diabetes mellitus and hypertension. The clinical pharmacists developed and implied individualized pharmaceutical care for patient′s condition and at the same time， according to the clinical efficacy of drugs to adjust the pharmaceutical care program. Using glucocorticoid and glycemic control drugs as the starting point，the clinical pharmacists carried out pharmaceutical care for the whole patient and and? find and solve problems in drug therapy in time to ensure rational， safe and effective drug use， and improve clinical cure rate. The clinical pharmacists have accumulated the experience of medical care in patients with sudden deafness associated with diabetes and hypertension in treatment of sudden deafness， regulating blood glucose， blood pressure and other drugs in the practice of clinical drug therapy. Providing "patient oriented" clinical pharmacy， formulation and analysis of individualed treatment plan are important for clinical pharmacists in the participation of clinical service. Given to patients with pharmaceutical care， not only can doctors and patients were given with drug treatment pharmaceutical professional help， but also the patients can have a treatment with a stable emotion， and which could enhance patients′ confidence， increase patient satisfaction， increase medication compliance， reflect the value of clinical pharmacists.

[Key words] Sudden deafness; Diabetes Mellitus; Hypertension; Pharmaceutical care

突發性耳聾（全稱突發感音神經性耳聾），是一種臨床常見疾病。它是指突然發作、不明原因的中重度感音神經性耳聾，通常在數分鐘至一天內聽力下降至最低點，發病中多伴有耳鳴，部分伴有眩暈[1-5]。本病的發病機制尚未肯定，但臨床研究顯示，糖尿病、高血壓、高血脂、血黏度、腦供血不足和肝臟疾病是突發性耳聾的危險因素[2，6-8]。……