胸外科围术期抗菌药物使用全程持续干预的效果评价  

Evaluation on the Effect of Continuous Intervention on the Antibiotics Use during the Perioperative Period in the Department of Thoracic Surgery

作　　者：刘晓凤[1] 简晓顺[1] 周明[1] 唐海波[1] 姜顺军[2] 

机构地区：[1]广州医科大学附属肿瘤医院,广州510095 [2]广州医科大学附属第一医院,广州510120

出　　处：《中国药房》2015年第14期1977-1979,共3页China Pharmacy

基　　金：广东省自筹经费类科技计划项目(No.2013-6)

摘　　要：目的:评价临床药师在胸外科围术期抗菌药物合理使用全程持续干预的效果。方法:收集广州医科大学附属肿瘤医院2012年1-12月(干预前)、2013年7月-2014年6月(干预后)胸外科行手术治疗的患者病历,各300例。对干预前后抗菌药物使用种类以及使用频率、联合用药情况、人均抗菌药物使用时间以及种类、人均抗菌药物费用占住院费用比例,以及抗菌药物使用合理性进行比较。结果:干预后患者抗菌药物使用种类较干预前少,且第一代头孢菌素类药物使用比例明显升高,差异有统计学意义(P<0.05);干预前患者围术期抗菌药物单用比例为74.00%、联用比例为26.00%,干预后患者围术期抗菌药物单用比例为97.37%、联用比例为2.63%,干预前后比较差异有统计学意义(P<0.05);干预后患者人均抗菌药物使用时间、人均抗菌药物使用种类以及人均抗菌药物费用占住院费用比例均明显低于干预前,干预后抗菌药物使用合理性明显高于干预前,差异均有统计学意义(P<0.05)。结论:临床药师在胸外科围术期抗菌药物使用中全程持续干预可明显提高抗菌药物临床使用合理性,减少抗菌药物临床使用量,降低患者医疗费用,提升临床医疗服务质量。OBJECTIVE： To evaluate the effect of continuous intervention by clinical pharmacists on the antibiotics use during the perioperative period in the department of thoracic surgery. METHODS： The records of patients with thoracic surgery in the Cancer Center of Guangzhou Medical University from Jan. to Dec. 2012 （before intervention） and Jul. 2013 to Jun. 2014 （after inter- vention） were collected, 300 cases for each. The types, frequency of use, combination, average time and types of antibiotics, the proportion of average cost in the hospitalization costs and the rationality of antibiotics use were compared. RESULTS： After inter- vention, the types of antibiotics were less than before and the use of the first-generation cephalosporins was significantly increased, with significant difference （P〈0.05）. Before intervention, the proportion of only use of antibiotics in perioperative period was 74.00% and the combination was 26.00%; after intervention, they were respectively 97.37% and 2.63%. There was significant difference （P〈0.05）. After intervention, the average time and types of antibiotics and the proportion of average cost in the hospitaliza- tion costs were significantly lower than before; the rationality of antibiotics use was significantly higher than before, with signifi- cant differences （P〈0.05）. CONCLUSIONS： The continuous intervention by clinical pharmacists during the perioperative period in the department of thoracic surgery can significantly improve the rationality of antibiotics, reduce the amount of antibiotics in clini- cal use and the medical costs and improve clinical quality of service.

关 键 词：胸外科围术期 抗菌药物 全程持续干预 临床效果 

分 类 号：R969.3[医药卫生—药理学] R978.1[医药卫生—药学]