乳腺外科围术期抗菌药物应用管理策略  

Strategies for management of antibiotics used in breast surgery during perioperative period

作　　者：陈敏[1] 周陶友[1] 蒲丹[1] 莫春梅[1] 杨天桂[1] 刘芳[1] 李幼平[2] 

机构地区：[1]四川大学华西医院医疗质量管理部,四川成都610041 [2]四川大学华西医院循证医学中心,四川成都610041

出　　处：《中华医院感染学杂志》2011年第23期5035-5038,共4页Chinese Journal of Nosocomiology

摘　　要：目的探讨乳腺外科围术期抗菌药物合理应用方案和管理策略实施的可行性,以及对医疗质量指标和卫生经济学指标的综合影响。方法以普外科乳腺手术病例为研究对象,分为干预组和对照组,每组各47例,共94例,采用1∶1病例对照研究;干预组采用围手术期抗菌药物合理应用管理策略,对照组按照外科医师传统用药方法;比较两组住院天数、住院总费用、抗菌药物费用、用药合理性比例、医院感染率。结果干预组患者住院时间为(7.28±2.16)d,较对照组的(9.19±2.04)d明显缩短(P=0.0000);干预组住院总费用、抗菌药物费用分别为(4222.59±1056.57)元、(685.82±299.94)元,较对照组的(5457.84±1768.18)元、(1049.50±453.05)元,显著减少,差异有统计学意义(P<0.05);干预组用药合理性为87.24%,而对照组为23.40%,二者差异有统计学意义(P<0.01);两组患者均未发生医院感染。结论围手术期抗菌药物合理应用管理策略实施后,乳腺手术围手术期抗菌药物的预防性使用更加合理,住院天数和药品费用明显减少;进而促进安全、有效、经济、合理地使用抗菌药物,为医院降低单病种费用提供了一种有效且可行的模式。OBJECTIVE To discuss the feasibility of reasonable applications and management strategy of antibiotics during perioperative period of breast surgery,and to observe the impact of these strategies on the quality of medical care and hygienic economical parameters. METHODS A total of 94 breast surgery patients were arranged into intervention group（47 cases） and control group（47 cases）,respectively.The intervention group received management strategies of rational use of antibiotics in perioperative period and the control group were under conventional surgical treatment methods.Then the Days of hospitalization,the total cost of hospitalization and antibiotics,the proportion of rational drug use and hospital infection rates were compared using the 1∶1 case-control study. RESULTS Compared with the control group（9.19±2.04）,hospitalization time of the intervention group（7.28±2.16 days） was significantly shorter（P=0.0000）.The total cost of hospitalization and antibiotics of the intervention group were（4222.59±1056.57） yuan and（685.82±299.94） yuan respectively was significantly reduced,compared with the control group（5457.84±1768.18） yuan and（1049.50±453.05 yuan）（P0.05）.The ratio of rational drug use of intervention group is 87.24%,while the control group was 23.40%,and the difference was statistically significant（P0.01）.Additionally,there is no nosocomial infection both in two groups. CONCLUSION After the implementation of the perioperative management strategies of rational use of antibiotics,the perioperative prophylactic use of antibiotics is more reasonable and the hospitalization and drug costs are significantly reduced in breast surgery.Then these strategies promote the safety,effects,economical and rational use of antibiotics,and provide an effective and viable model to reduce the single disease hospital cost.

关 键 词：围手术期 抗菌药物 管理策略 干预性研究 

分 类 号：R978.1[医药卫生—药品]