【摘要】 目的 提高行活体肝移植患儿治疗的有效性和安全性。方法 收集医院2017年7月至2023年12月接受活体肝移植患儿的多学科联合会诊（MDT）病历资料，提取并分析患儿的基本资料、围术期抗感染药物使用情况、病原学检查结果，临床药师参与MDT的目的及会诊建议采纳情况，以及患儿转归情况等。结果 共收集患儿137例，开展MDT 154例次，其中临床药师参与141例次；患儿年龄以> 6个月至1岁居多（68例次、32.85%），原发疾病主要为胆道闭锁（96例次、70.07%）；器官移植科（154例次、100.00%），儿科（147例次、95.45%），儿童重症监护室（142例次、92.21%）参与患儿MDT较多；临床药师参与MDT的目的以指导选择/调整抗感染药物为主（112例次、79.43%）,31例术后早期病原学检查结果为阳性，共检出54株病原菌，其中革兰阴性菌的检出率最高（31株、57.41%），抗感染药物主要为头孢哌酮舒巴坦（1∶1,68例、49.64%）；临床药师意见的全采纳率为83.69%，其中痊愈率为42.37%。结论 临床药师参与MDT，可为接受活体肝移植患儿个体化用药提供专业的药学意见，从而进一步保障治疗的有效性和安全性。更多还原

【Abstract】 Objective To improve the effectiveness and safety of pediatric living liver transplantation.Methods The medical records of children underwent the living liver transplantation and received multi-disciplinary treatment(MDT) in the hospital from July2017 to December 2023 were collected. The children′s basic information,perioperative use of anti-infective drugs,pathogen examination,purpose of clinical pharmacists participating in MDT,adoption of consultation recommendations and children′s disease outcomes were extracted and analyzed.Results A total of 137 children were included,who underwent 154 case times of MDT,with clinical pharmacists participating in 141 case times. The children were mainly in the range of > six months to one year(68 case times,32. 85%),and the main primary disease was biliary atresia(96 case times,70. 07%). The staff in the organ transplantation department(154 case times,100. 00%),pediatrics(147 case times,95. 45%) and pediatric intensive care unit(142 case times,92. 21%) participated more in pediatric MDT. The purpose of clinical pharmacists participating in MDT was mainly to guide the selection/adjustment of anti-infective drugs(112 case times,79. 43%). The early postoperative pathogen examination in31 children was positive,and 54 strains of pathogenic bacteria were detected,in which the detection rate of Gram-negative bacteria was the highest(31 strains,57. 41%),and the main anti-infective drug was cefoperazone and sulbactam(1∶1,68 cases,49. 64%). The overall adoption rate of clinical pharmacists′ opinions was 83. 69%,with a cure rate of 42. 37%.Conclusion The clinical pharmacists′ participation in MDT can provide professional pharmaceutical recommendations for individualized medication in children undergoing living liver transplantation and further ensure the effectiveness and safety of treatment.更多还原