髋关节置换术围手术期抗菌药物预防使用干预前后对比研究  

Comparative study of perioperative prophylactic use of antibiotics in the perioperative period of hip replacement

作　　者：王静[1] 王述蓉 

机构地区：[1]广元市中心医院药学部,四川广元628000 [2]西南医科大学附属医院药学部

出　　处：《西南医科大学学报》2017年第1期55-58,共4页Journal of Southwest Medical University

摘　　要：目的:探讨临床药师干预对髋关节置换术预防用抗菌药物的使用情况的影响。方法:以2011年9月至2013年2月本院处方1 180份为干预前对照,以2013年3月至2014年9月期间处方1 228份为干预对象。2013年3月1日起,选择若干名有至少3年工作经验的临床药师,通过查房、会诊、参与病例讨论以及治疗方案的制定,对髋关节置换术预防用抗菌药进行干预,实施动态监控。比较干预前后抗菌药物合理性和使用情况。结果:经临床药师干预后,髋关节置换术预防用抗菌药物以头孢类和青霉素为主,一些毒副作用大、价格高的药品已不再使用,使用频次排名前五的药品亦主要为低副作用、平价的药品。同时,干预后抗菌药物应用时间以及患者住院时间明显缩短,抗菌药物费用显著减少,抗菌药合理应用情况总体较干预前也有显著改善。结论:临床药师干预明显改善了髋关节置换术的预防用抗菌药物合理性用药情况,使药品的使用更加高效、平价、低副作用,趋于合理化。Objective： To study the effect of perioperative prophylactic use of antibiotics in patients with hip joint replacement. Methods： 1 180 prescriptions from September 2011 to February 2013 were selected as pre- intervention group, and 1 228 prescriptions from March 2013 to September 2014 were selected as intervention group. From March 1, 2013, several clinical pharmacists with at least 3-year experience were chosen to participate in the prophylactic use of antibiotics in patients with hip joint replacement and to dynamically monitor the interventions through medical warding, eonsulation, case discussion, and drafting therapeutic regimen. The rationality of the usage of antibiotics was compared before and after interventions. Results： After the intervention by clinical pharmacist, the most commonly used antibiotics are cephalosporin and penicillin. Those with toxicity, serious side-effects and high cost have no longer been used. The top-five most commonly used antibiotics are all with mild side effects and low cost. At the same time, the duration of antibiotics use and hospitalization were significantly shorter, expense was significantly reduced after pharmacist＇s participation, and rationality of antibiotics usage also much improved. Gonclusion： Clinical pharmacists play an important role in the usage of antibiotics in patients with hip replacement surgery.

关 键 词：临床药师干预 髋关节置换术 抗菌药物 合理化 

分 类 号：R969.3[医药卫生—药理学]