药师干预闭合性骨折切开复位内固定术围手术期预防用药效果分析  

Analysis on the effect of pharmacists′ intervention in the perioperative period of open reduction and internal fixation for closed fractures

作　　者：杜晓俊 刘威 齐丽平 许春燕 DU Xiaojun;LIU Wei;QI Liping;XU Chunyan(Clinical Pharmaceutics Room,the First People′s Hospital of Zhumadian,Zhumadian,Henan 463000,China)

机构地区：[1]驻马店市第一人民医院临床药学室

出　　处：《现代医药卫生》2020年第3期343-345,348,共4页Journal of Modern Medicine & Health

摘　　要：目的考察临床药师干预闭合性骨折切开复位内固定术围手术期抗菌药物预防应用的效果。方法分别抽取该院2014年5-6月(干预前组)、2015年5-6月(干预后组)和2016-2018年5-6月(持续干预组)闭合性骨折切开复位内固定术出院患者病历各100份,对围手术期预防性应用的药物选择、给药剂量、给药途径、给药时机、给药疗程和药物经济性等合理性进行比较。结果经临床药师干预,闭合性骨折切开复位内固定术围手术期抗菌药物使用率明显降低,品种选择合理率、用药时机合理率、用药疗程合理率明显升高,预防使用抗菌药物平均费用明显减少,差异均有统计学意义(P<0.05)。持续干预抗菌药物使用率则降至6.0%,干预前、后切口感染率均为0。结论临床药师对闭合性骨折切开复位内固定术围手术期预防性应用抗菌药物的干预是可行、有效的,对Ⅰ类切口围手术期预防性用药的安全、有效、合理、经济具有积极的促进作用,也为进一步规范其他Ⅰ类切口围手术期预防用药提供了可行性的干预模式。Objective To investigate the effect of clinical pharmacists on the preventive use of antibiotics in the perioperative period of open reduction and internal fixation for closed fractures.Methods 100 discharged medical records were collected from the hospital during from May to June in 2014(before intervention group),from May to June in 2015(after intervention group)and from May to June from 2016 to 2018(continuous intervention group),respectively.The rationality of perioperative prophylactic application of antibiotics was compared in terms of medicine selection,dosage,route of administration,administration occasion,treatment course and economy of drug,etc.Results After the intervention of clinical pharmacists,the utilization rate of antibiotics in the perioperative period of open reduction and internal fixation for closed fractures decreased significantly,the reasonable rate of variety selection,the reasonable rate of timing of medication,and the reasonable rate of course of medication increased significantly,and the average cost of antibiotics for prevention decreased significantly,with statistically significant differences(P<0.05).The rate of continuous intervention decreased to 6.0%,and the rate of incision infection before and after intervention was 0.Conclusion Clinical pharmacists in blunt open reduction and internal fixation of fracture of perioperative prophylactic use of antimicrobial agents intervention is feasible and effective,inⅠincision is safe,effective perioperative prophylactic use of antibiotics,reasonable,a positive role in promoting economy,also in order to further regulate otherⅠincision perioperative prophylaxis,provides the feasibility of intervention model.

关 键 词：闭合性骨折切开复位内固定术 围手术期 抗菌药物 药师 干预 预防用药 

分 类 号：R951[医药卫生—药学]