妊娠期哺乳期药物咨询门诊的开设与实践Establishment and practice of drug consultation clinic for pregnant and lactating women
叶淑雅;郑彩虹;
摘要(Abstract):
目的交流妊娠期和哺乳期药物咨询门诊的工作模式、基本要素和累积数据。方法以微信形式初步调研了浙江省妊娠期和哺乳期用药相关的药学门诊的开设概况,并就我院2016年1月至2019年8月药学门诊的咨询要素、就诊人次、构成、咨询排名前10位的药品和疾病种类以及常见的非药物因素,进行阶段性的回顾分析和讨论。结果妊娠期哺乳期用药门诊的专科特色决定了非药物性相关信息收集的重要性;门诊咨询问题以妊娠期用药为主,其中意外妊娠后的药物咨询人次远多于备孕咨询;咨询药品占比较高的为抗菌药物、紧急避孕药和抗感冒药物;非药物因素以饮酒、X线、CT检查相关的咨询为主;排除咨询者自行用药外,主要用药原因为妊娠合并甲状腺疾病、乙型肝炎和多囊卵巢综合征。结论在妊娠期和哺乳期药物咨询门诊中,需要关注咨询者用药之外的信息,并给予个体化建议,而科普宣教远重于事后的药学服务。
关键词(KeyWords): 妊娠;哺乳期;咨询;用药;药学门诊
基金项目(Foundation):
作者(Author): 叶淑雅;郑彩虹;
Email:
DOI: 10.14053/j.cnki.ppcr.202101019
参考文献(References):
- [1] 张川,张伶俐,陈力,等.妊娠期用药调查研究的系统评价[J].中国药学杂志,2012,47(11):858-862.
- [2] Hale TW,Rowe HE.药物与母乳喂养(辛华雯等译)[M].上海:世界图书出版公司,2019.
- [3] Briggs GG,Freeman RK,Yaffe SJ.妊娠期和哺乳期用药(杨慧霞等译)[M].第7版.北京:人民卫生出版社,2008.
- [4] Frost Widnes SK,Schjott J.Drug use in pregnancy--physicians′ evaluation of quality and clinical impact of drug information centres[J].Eur J Clin Pharmacol,2009,65(3):303-308.
- [5] Widnes SF,Schjott J,Eide GE,et al.Teratogenic risk perception and confidence in use of medicines in pairs of pregnant women and general practitioners based on patient information leaflets[J].Drug Saf,2013,36(6):481-489.
- [6] 中国药师协会.关于印发《药师提供互联网科普与咨询服务的专家共识》的通知[EB/OL].[2020-9-9].http://www.clponline.cn/info_show.asp?infoid=573
- [7] Evans MI,Johnson MP,Yaron Y,et al.产前诊断(段涛等译)[M].北京:人民卫生出版社,2010.
- [8] 贺亚琴,郑玉华,王晓成,等.出生缺陷影响因素的meta分析[J].中国计划生育学杂志,2012,20(4):233-236.
- [9] Frederiksen LE,Ernst A,Brix N,et al.Risk of adverse pregnancy outcomes at advanced maternal age[J].Obstet Gynecol,2018,131(3):457-463.
- [10] 薛瑜,廖明,覃爱平.高龄男性生育问题的研究进展[J].临床医学研究与实践,2019,4(8):189-191.
- [11] 李新虎,王劲峰,郑晓瑛,等.出生缺陷发生的环境因素研究进展[J].中国公共卫生,2005,21(10):1158-1160.
- [12] Sheiner EK,Sheiner E,Hammel RD,et al.Effect of occupational exposures on male fertility:literature review[J].Ind Health,2003,41(2):55-62.
- [13] 贺晶,罗洁.再生育的临床问题[J].中华妇幼临床医学杂志:电子版,2014,(2):126-130.
- [14] Momeni M,Danaei M,Kermani AJ,et al.Prevalence and risk factors of low birth weight in the southeast of Iran[J].Int J Prev Med,2017,8:12.
- [15] Sass L,Urhoj SK,Kj■rgaard J,et al.Fever in pregnancy and the risk of congenital malformations:a cohort study[J].BMC Pregnancy Childbirth,2017,17(1):413.
- [16] Botto LD,Panichello JD,Browne ML,et al.Congenital heart defects after maternal fever[J].Am J Obstet Gynecol,2014,210(4):359.e1-359.e11.
- [17] Gustavson K,Ask H,Ystrom E,et al.Maternal fever during pregnancy and offspring attention deficit hyperactivity disorder[J].Sci Rep,2019,9(1):9519.
- [18] Mosley JF,Smith LL,Dezan MD.An overview of upcoming changes in pregnancy and lactation labeling information[J].Pharm Pract(Granada),2015,13(2):605.
- [19] 特殊人群普通感冒规范用药专家组.特殊人群普通感冒规范用药的专家共识[J].国际呼吸杂志,2015,35(1):1-5.
- [20] May PA,Blankenship J,Marais AS,et al.Maternal alcohol consumption producing fetal alcohol spectrum disorders(FASD):quantity,frequency,and timing of drinking[J].Drug Alcohol Depend,2013,133(2):502-512.
- [21] Muggli E,Matthews H,Penington A,et al.Association between prenatal alcohol exposure and craniofacial shape of children at 12 months of age[J].JAMA Pediatr,2017,171(8):771-780.
- [22] American College of Obstetricians and Gynecologists.Committee on Health Care for Underserved Women.Committee opinion no.496:At-risk drinking and alcohol dependence:obstetric and gynecologic implications[J].Obstet Gynecol,2011,118(2 Pt 1):383-388.