3种清洁手术围术期预防用抗菌药物的干预与效果评价  

Intervention and Effect Evaluation of Perioperative Prophylactic of Antibiotics in 3 Clean Operations

作　　者：王雨波[1] 邹玉刚[1] 熊德庆[1] 

机构地区：[1]遵义医学院第三附属医院药剂科,遵义市563002

出　　处：《中国药房》2011年第30期2811-2814,共4页China Pharmacy

摘　　要：目的:评价我院围术期预防用抗菌药物全程持续干预的效果。方法:将我院2009年7月-2010年12月普外科360例清洁手术(甲状腺手术、乳腺手术、疝气修补术)患者分为非干预组和2轮干预组(每组均120例),对抗菌药物应用情况、合理性评价结果及所占费用等进行对比、分析。结果:第2轮干预后3种清洁手术预防用抗菌药物选择逐渐规范;预防用药能把握时机;预防用抗菌药物疗程≤24h者达75.83%,明显高于非干预组的5.00%;平均住院药品费用、平均住院抗菌药物费用分别为554.23元、50.41元,均显著低于非干预组的1071.73元和514.38元(P<0.01);平均住院时间为6.94d,明显低于非干预组的7.92d(P<0.05);围术期抗菌药物合理应用率为66.34%,显著高于非干预组的0.83%(P<0.01)。结论:采取宣传教育、技术和行政干预等相结合的合理用药干预措施可行、有效,可为深化公立医院改革、降低医疗费用提供一种有效、可行的干预模式。OBJECTIVE：To evaluate the influence of throughout intervention on perioperative prophylactic application of antibiotics in our hospital.METHODS：360 patients underwent 3 clean operations in general surgery department from Jul.2009 to Dec.2010 were divided into two rounds intervention groups （240 cases） and non-intervention group（120 cases）.The antibiotics use,reasonable evaluation results and cost of three groups were analyzed comparatively.RESULTS：After the intervention of the second round,antibiotic selection was standard gradually and the opportunity could be grasped in prophylactic use of antibiotics;the course of treatment was less than 24 h （75.83%） in intervention group,which was significantly higher than 5.00% of non-intervention group;the average hospital cost was 554.23 yuan and average antibiotics cost was 50.41 yuan,which were significantly lower than 1 071.73 yuan and 514.38 yuan of non-intervention group （P0.01）;the average hospital days（6.94 d）was significantly lower than 7.92 d of non-intervention group （P0.05）;the rate of rational use of antibiotics increased to 66.34%,which was significantly higher than 0.83% of non-intervention group （P0.01）.CONCLUSION：Intervention measures for rational drug use,such as propaganda and education,technology and administrative intervention,are feasible and effective.It is a feasible and effective intervention model for deepen the reform of public hospitals and reducing medical costs.

关 键 词：清洁手术 抗菌药物 干预 效果 

分 类 号：R969.3[医药卫生—药理学] R287[医药卫生—药学]