抗菌药物专项整治前后我院腹腔镜胆囊切除术围术期抗菌药物预防性使用分析  

Analysis on the Application of Perioperative Antibiotics for Laparoscopic Cholecystectomy before and after Rectification of Antibiotics in Our Hospital

作　　者：王惠霞[1] 滕月鹏[1] 古殿杰 

机构地区：[1]兰州市第二人民医院药剂科,兰州730046

出　　处：《中国药房》2015年第5期579-582,共4页China Pharmacy

基　　金：兰州市科技计划项目(No.2011-2-9)

摘　　要：目的:将腹腔镜胆囊切除术(LC)围术期预防用药纳入普外科Ⅰ类切口手术管理。方法:将LC预防用抗菌药物为专项点评项目,采用临床药师技术干预与医院行政干预相结合,以PDCA循环管理法实施干预,对我院2009年7-12月(干预前)、2011年7-12月(第一阶段干预后)、2012年7-12月(第二阶段干预后)普外科病历资料中单纯胆囊结石、胆囊息肉型LC患者315例,进行抗菌药物预防应用合理性评价,并对干预前后情况进行比较、分析。结果:与干预前比较,第一阶段、第二阶段干预后LC预防用抗菌药物分别由100%降至62.96%、52.68%,总体降幅达70.21%(P<0.05);LC抗菌药物费用占药品总费用的比例分别由35.39%降至12.89%、1.40%,总体降幅达96.04%(P<0.05);LC预防用抗菌药物合理率由0分别升至43.75%、74.17%(P<0.05);LC抗菌药物使用品种分别由七大类13个品种减少至四大类8个品种、三大类5个品种;LC患者平均住院天数分别由9.55 d降至8.23、7.50d。干预前后,LC患者均未发生切口感染。结论:将LC预防用药纳入普外科Ⅰ类切口手术管理,可有效规范使用抗菌药物;临床药师的技术干预与医院行政干预后,可提高抗菌药物临床应用合理性。OBJECTIVE:To enroll laparoscopic cholecystetomy(LC)perioperative prophylaxis into the general surgery incision surgery typeⅠ management.METHODS:LC antibiotics prevention as a special project review was combined with clinical pharmacist intervention and hospital administrative intervention to intervene the PDCA cycle management,medical information of LC patients in our hospital with simple gallstones and gallbladder polyps during Jul.-Dec. 2009(before intervention),Jul.-Dec. 2011(after stage 1intervention)and Jul.-Dec. 2012(after stage 2 intervention)in general sugery department were collected to evaluate the rationality of prophylacticuse of antibiotics,and compared comparatively before and after intervention. RESULTS:Compared with before intervention,the ratio of antibiotics for prophylactic use in LC decreased from 100% to 62.96% and 52.68% respectively,decreasing by70.21% in total(P<0.05)after the intervention of stage 1 and 2;the proportion of antibiotics cost in the total drug cost declined from 35.39% to 12.89% and 1.40% respectively,decreasing by 96.04% in total;the reasonable rate of antibiotics for preoperative use went up to 43.75% and 74.17% from 0. The species of LC antibiotics medication were decreased from 7 categories 13 varieties to 4 categories 8 varieties and 3 categories 5 varieties respectively;the mean time of LC patients hospital stay was decreased from9.55 d to 8.23 d and 7.50 d. There were no incision infection in LC patients before and after intervention. CONCLUSIONS:It prophylactic use of antibiotics in LC could standard to include LC prophylactic medication into the management of typeⅠ incision operations in general surgery department. The interventions of clinical pharmacists could promote rational use of antibiotics.

关 键 词：腹腔镜胆囊切除术 抗菌药物 围术期 预防用药 

分 类 号：R47[医药卫生—护理学] R619[医药卫生—临床医学]