儿童急性阑尾炎围术期抗菌药物合理应用的干预研究  

Intervention Study on the Rational Use of Antibiotics in Perioperative Period for Children with Acute Appendicitis

作　　者：曹松山[1] 陶兴茹[1] 裴保方[1] 段彦彦[1] 刘晓玲[1] 陈海燕[1] 

机构地区：[1]郑州市儿童医院药学部,郑州450053

出　　处：《中国药房》2016年第32期4584-4586,共3页China Pharmacy

基　　金：郑州市2014年度"常州四药临床药学科研基金"科研项目(No.CZSYJJ14004)

摘　　要：目的:为儿科临床合理应用抗菌药物提供参考。方法:采用回顾性分析方法,选取我院2011年7月-2013年6月(干预前)485例和2013年7月-2015年6月(干预后)503例急性阑尾炎患儿的出院病历,对其围术期抗菌药物应用的合理性进行对比分析。结果:经综合干预后,我院急性阑尾炎患儿围术期抗菌药物品种选择、联合用药和药物更换的合理率分别由干预前的67.42%、80.82%、80.21%上升至94.23%、93.24%、88.27%,用药疗程由干预前的(10.19±3.49)d缩短至(7.83±3.15)d,病程记录中有用药分析的比例由干预前的83.09%上升至89.86%,差异均有统计学意义(P<0.05);而给药剂量、给药频次的合理率虽有所上升,但差异无统计学意义(P>0.05)。结论:采取综合干预措施,可提高围术期抗菌药物应用的合理性,对规范儿科围术期抗菌药物的合理应用具有一定的借鉴作用,我院急性阑尾炎患儿围术期抗菌药物不合理使用的现象仍不容乐观,有待进一步持续干预。OBJECTIVE： To provide reference for rational use of antibiotics in pediatric department. METHODS： Retrospective analysis was used to select discharged medical records of 485 children with acute appendicitis from Jul. 2011 to Jun. 2013 （before intervention） and 503 cases from Jul. 2013 to Jun. 2015 （after intervention）, compare and analyze the rational use of antibiot- ics in perioperative period. RESULTS： After intervention, the rational rates of antibiotic selection, combined medication and replacement drugs of children with acute appendicitis in our hospital increased from 67.42% , 80.82% , 80.21% to 94.23% , 93.24%, 88.27%, medication course decreased from （10.19 ±3.49） d to （7.83 ±3.15） d, the percentage of medication analysis in progress note increased from 83.09% to 89.86%, the differences were statistically significant （P〈0.05） ; though rational rate of dosage and frequency increased, the difference was no statistically significant （P〉0.05）. CONCLUSIONS： Comprehensive inter- vention can obviously improve the rational use of perioperative antibiotics, and also play a reference role in standardizing the rational use of perioperative antibiotics in pediatric department. The irrational use of antibiotics in perioperative period in our hospital is still not optimistic, which needs further intervention.

关 键 词：儿童 急性阑尾炎 围术期 抗菌药物 合理用药 干预 

分 类 号：R969.3[医药卫生—药理学]