抗菌药物应用专项整治对普外科围手术期预防用药的影响  

Effect of special rectification for clinical use of antibiotics on antibiotics prophylaxis during perioperative period of general surgery

作　　者：唐叶秋[1] 归莱[1] 殷卫清[1] 

机构地区：[1]常熟市第一人民医院临床药学室,江苏常熟215500

出　　处：《中华医院感染学杂志》2013年第24期6089-6090,6146,共3页Chinese Journal of Nosocomiology

基　　金：江苏省中医药局科技基金资助项目(LZ13237)

摘　　要：目的了解抗菌药物临床应用专项整治对普外科围手术期抗菌药物应用的影响,为临床合理用药提供参考依据。方法选取2010年9-11月75例(对照组)和2011年9-11月89例(治理组)行乳腺、甲状腺手术的患者临床资料;采用回顾性调查方法,对患者的基本情况、手术情况、抗菌药物使用等逐项记录,建立Excel数据库,采用t检验、χ2检验进行相关资料统计分析。结果专项整治前后抗菌药物使用率显著降低,分别为100.00%、3.37%,预防用药指征符合率从13.33%提高至66.67%;首剂给药时间合理率从0提高至66.67%;平均用药时间从(3.20±1.22)d缩短至(0.03±0.16)d;抗菌药物平均费用由(712.05±360.98)元降至(8.55±54.99)元,抗菌药物费用占药品总费用的比例由50.57%下降为0.60%、抗菌药物费用占住院总费用的比例由12.23%下降为0.15%,差异有统计学意义(P<0.05)。结论抗菌药物临床应用专项整治,提高了医院乳腺甲状腺围手术期抗菌药物应用的合理性;充分证明医院专项整治的各项措施是可行和有效的,并为新一轮专项整治积累了宝贵经验。OBJECTIVE To investigate the impact of the special rectification for clinical application of antibiotics on the antibiotics prophylaxis during perioperative period of general surgery so as to provide references for clinical rational use of antibiotics. METHODS The medical records of the 75 patients （the control group） from Sep. to Nov. 2010 and 89 cases （the rectification group） from Sep. to Nov. 2011 undergoing breast and thyroid surgery were selected by means of retrospective investigation, then the basic condition, operation situation, and the use of antimicrobial agents of the patients were recorded item by item, the Excel database was established, and the t-test and ehi-square test were performed for the statistical analysis of related data. RESULTS The utilization rate of antibiotics was 100.00% before the special rectification, 3.37 % after the special rectification; the coincidence rate of the antimicrobial agents indications was raised from 13.13% to 66.67 % ; the reasonable rate of the first medication was increased from 0 to 66.67% ; the median duration was shortened from （3.20±1.22） days to （0.03±0.16） days; the average cost of antibiotics fell from （712.05 ±360.98） yuan to （8. 55±54.99） yuan; the proportion of the cost of antibiotics in the overall cost of medicine decreased from 50.57% to 0.60%, while the proportion of cost of antibiotics out of the total hospitalization cost decreased from 12.23% to 0.15%, the difference was statistically significant （P〈0.05）. CONCLUSION The special rectification for clinical application of antibiotics can significantly improve the rationality of use of antibiotics during the perioperative period of thyroidectomy and mammeetomy; the measures taken for the special rectification are proved to be feasible and effective, which has accumulated valuable experience for a new round of special rectification.

关 键 词：乳腺 甲状腺 围手术期 抗菌药物 专项整治 

分 类 号：R978.1[医药卫生—药品]