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OBJECTIVE:To investigate the role of clinical pharmacists in the treatment for patients with chronic renal failure. METHODS:Clinical pharmacists participated in the treatment process for a patient with chronic renal failure during uremia period;assisted physicians to optimize and improve therapy plan from correcting anemia,controlling blood pressure,improving heart func-tion and regulating ion disorder,etc.;suggested adding dosing frequence of Felodipine sustained-release tablet,Metoprolol tartrate tablet and Shenqiong glucose injection,and giving Benazepril hydrochloride tablet and Isosorbide 5-mononitrate sustained-release tablet. They also suggested adjusting the dosage of rhEPO and the dosage form of ferralia,increasing the dosage of Calcitriol cap-sule and Calcium carbonate tablet,decreasing dosing frequence of 5% Glucose injection and Levocarnitine for injection,and giv-ing Vitamine B12 tablet. Therapeutic efficacy and ADR should be observed closely during treatment,and medication education should be performed for the patient. RESULTS:Physicians adopted the suggestions of clinical pharmacists. The patient was im-proved and discharged from hospital with drugs 28 days later. CONCLUSIONS:Clinical pharmacists participate in the individual-ized treatment for patients with chronic renal failure and assist physicians to optimize therapy plan,which promote the clinical effec-tiveness and safety of drug treatment.
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Objective To evaluate the efficacy of the RevoLix 70 Watt 2 micron continuous wave laser vaporesection for treatment of large volume benign prostatic hyperplasia(BPH,＞80 g).Methods Forty-five patients with obstructive BPH were treated with 2 micron continuous wave laser vaporesection.The age ranged from 57 to 88 years with a mean of 69 years.Nine patients had acute urinary retention.Mean prostatic volume was(96±1 3)ml(ranged from 80 to 128 m1).Eight cases were given suprapubic puncture.All cases were successfully anesthetized by using epidural anesthesia.At the beginning of the operation,the distal resection border close to the verumontanum was marked and laser incisions were performed at 5 and 7 o'clock lithotomy position.Firstly,median lobe was vaporeseeted closely along capsule from bladder neck to verumontanum.Secondly,prostate at 12 o'clock was vaporesected until the capsule was reached,and both lateral lobes were dissected downward.Thirdly,the apical position was enucleated by sheath,and then prostate was vaporesected from the tissue in 12 o'clock position to the tissue at 6.It was important to follow the 2 principles:inner to extra,up to down.Transfusion rate,resection time,time of indwelling catheter,improvement in urinary flow rate(Qmax),international prostate symptom score(IPSS)and quality of life(QOL)were measured.Results AIl cases were successfully operated.except one whose left lateral lobe was left due to heavy fluctuation of heart rate and blood pressure in operation.The mean operation time was (104±12)min.Transfusions were not necessary in any patients.The catheter was indwelled for 3 to 5 d postoperatively.One case had urethral stricture 3 weeks after operation,and urinated free after 22 times urethral sounding disj unctively.All cases were followed up for 3-1 2 months.All patients were satisfied with voiding outcome,none had incontinence.Mean Qmax increased from(3.3±0.5)ml/spreoperatively to(16.5±1.5)ml/s postoperatively.IPSS decreased from 28.6±5.5 to 8.3±2.3 and QOL score decreased from 4.5±0.4 to 2.7±0.2.respectively(P＜0.01).No hemorrhage occurred after the operation.Conclusion RevoLix 2 micron continuous wave laser vaporesection for treatment of large volume BPH is a safe and effective relief therapy,and that in combination with enucleation could improve the efficiency of vaporesection.
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Objective To explore the efficacy and safety of greenlight photoselective vaporization of prostate(PVP) in high-risk older patients with benign prostatic hyperplasia(BPH).Methods A total of 96 high-risk older patients with BPH underwent PVP.The operative time,blood loss,indwelling catheterization and operative complications were observed.The variables such as IPSS,QOL,uroflowmetry,post-void residual urine volume(RUV) were recorded and calculated pre-and post-operatively.Results All the 96 patients safely got through perioperative period.The mean operative time was(24.8?6.5)min,intraoperative blood loss was(55.4?16.8)ml and postoperative indwelling catheterization was(1.6?0.7)d.IPSS and QOL scores decreased form preoperative 29.8?5.2 and 5.2?0.8 to postoperative 8.4?2.3 and(1.4?)0.5,respectively.Qmax increased from(5.6?2.8)ml/s to(16.7?3.2)ml/s,and RUV decreased from(168.0?22.5)ml to(24.6?5.81)ml.There were significant differences of these parameters between pre-and post-operation(P