临床药师干预前后心胸外科手术预防使用抗菌药物效果评价  

Effect Evaluation of Prophylactic Application of Antibiotics in Cardiothoracic Surgery before and after Clinical Pharmacist Intervention

作　　者：余爱荣[1] 范星[2] 赵燕[1] 朱水波[3] 辛华雯[1] 

机构地区：[1]广州军区武汉总医院临床药理科,武汉430070 [2]广州军区武汉总医院肾内科,武汉430070 [3]广州军区武汉总医院心胸外科,武汉430070

出　　处：《中国药房》2015年第26期3720-3722,共3页China Pharmacy

摘　　要：目的:探讨临床药师对心胸外科手术预防使用抗菌药物实施干预的效果。方法:调取2014年3-4月(干预前)、2014年6-7月(干预后)我院行心胸外科手术治疗的患者病历,分别纳入干预前组(n=115)和干预后组(n=119),对干预前后的预防使用抗菌药物效果进行比较。结果:经过干预,预防用药率从96.5%下降至72.3%,选药合理率从27.9%提高至94.2%,预防用药时间从(5.4±2.8)d缩短至(2.3±1.8)d,干预前后比较差异均有统计学意义(P<0.01);术后感染发生率从13.0%下降至5.9%,差异无统计学意义(P=0.074);平均住院时间、平均住院药费和平均住院费用均明显下降,差异均有统计学意义(P<0.05或P<0.01)。结论:临床药师对心胸外科手术预防使用抗菌药物实施干预,可有效控制感染发生,保障患者围术期预防用药的合理、安全。OBJECTIVE：To investigate the effect of clinical pharmacist intervention on prophylactic application of antibiotics in cardiothoracic surgery. METHODS：Medical records of patients underwent cardiothoracic surgery were collected from our hospital during Mar. to Apr. in 2014（before intervention）and during Jun. to Jul. in 2014（after intervention）. Those were divided into pre-intervention group（n=115）and post-intervention group（n=119）. The prophylactic application effect of antibiotics was compared before and after intervention. RESULTS：After intervention,the rates of prophylactic application were decreased significantly from 96.5% to 72.3%;the rationality rate of antibiotics selection was improved significantly from 27.9% to 94.2%;The course of prophylactic medication decreased significantly from（5.4±2.8）days to（2.3±1.8）days;the difference had statistical significance before and after intervention（P0.01）. The postoperative infection rate was decreased from 13.0% to 5.9%,the difference had no statistical significance（P=0.074）. The average hospitalization time,average drug costs,and average hospitalization expenses were decreased significantly,the difference had statistical significance（P0.05 or P0.01）. CONCLUSIONS：Clinical pharmacist intervention to prophylactic application of antibiotics in cardiothoracic surgery can control the infection effective and guarantee reasonable and safe use of drugs during perioperative period.

关 键 词：心胸外科手术 预防用药 临床药师 干预 

分 类 号：R978.1[医药卫生—药品]