临床药师对骨科Ⅰ类切口手术预防性使用抗菌药物的干预效果评价  

Evaluation of Clinical Pharmacist’s Intervention on Preventive Application of Antibiotics in TypeⅠIncision in Orthopedic Surgery

作　　者：张瑞[1] 韩明锋[2] 张玲玲[1] 廖巧 ZHANG Rui;HAN Mingfeng;ZHANG Lingling;LIAO Qiao(Dept. of Pharmacy, Fuyang the Second People’s Hospital, Anhui Fuyang 236015, China;Dept. of Respiratory and Critical Care Medicine, Fuyang the Second People’s Hospital, Anhui Fuyang 236015, China)

机构地区：[1]阜阳市第二人民医院药剂科,安徽阜阳236015 [2]阜阳市第二人民医院呼吸与危重症医学科,安徽阜阳236015

出　　处：《中国医院用药评价与分析》2020年第4期500-502,507,共4页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:评价临床药师干预骨科Ⅰ类切口手术预防性使用抗菌药物的效果。方法:阜阳市第二人民医院临床药师结合医院实际情况和外科围术期合理用药指标制定综合药学干预细则,对骨科Ⅰ类切口手术预防性使用抗菌药物实施药学干预。抽查2016年1—2月、2017年1—2月、2018年1—2月和2019年1—2月骨科Ⅰ类切口出院患者病历各50份,分别作为第1研究组、第2研究组、第3研究组和第4研究组,比较四组患者骨科Ⅰ类切口手术预防性使用抗菌药物的差异。从用药指征是否恰当、使用药物的时间和选择的药物是否符合相关规定等方面进行用药合理性评价。结果:第4研究组患者Ⅰ类切口手术抗菌药物预防性使用率为30.00%(15/50),较第1研究组(66.00%,33/50)显著降低,差异有统计学意义(P<0.05);第4研究组患者Ⅰ类切口手术预防性使用抗菌药物合理率为80.00%(12/15),较第1研究组(39.39%,13/33)明显升高,差异有统计学意义(P<0.05);第4研究组患者平均抗菌药物预防性使用疗程为1.4 d,较第1研究组(3.7 d)明显缩短,差异有统计学意义(P<0.05);第4研究组患者的用药指征恰当、药物选择合适和用药疗程适当等评价指标均较第1研究组显著改善。结论:药学综合干预有助于提高骨科合理用药水平,减少抗菌药物过度使用,避免细菌耐药的发生。OBJECTIVE:To evaluate the effects of clinical pharmacist’s intervention on preventive application of antibiotics in typeⅠincision in orthopedic surgery.METHODS:According to actual situation of the hospital and indicators of rational drug use in perioperative period of surgery,the clinical pharmacists from Fuyang the Second People’s Hospital formulated comprehensive pharmaceutical intervention rules.Medical records of typeⅠincision in orthopedic surgery from Jan.to Feb.2016,Jan.to Feb.2017,Jan.to Feb.2018,and Jan.to Feb.2019 were randomly extracted ad the study group 1 and study group 2,study group 3 and study group 4,with 50 cases in each group.Differences of preventive application of antibiotics in typeⅠincision in orthopedic surgery among four groups were compared.The rationality of drug application was evaluated,in terms of the appropriateness of medication indications,the application time of medication,and whether the selected drugs met the relevant regulations.RESULTS:The preventive application rate of antibiotics for typeⅠincision in orthopedic surgery in the study group 4 was 30.00%(15/50),significantly lower than that in the study group 1(66.00%,33/50),with statistically significant difference(P<0.05).The rational preventive application rate of antibiotics for orthopedic typeⅠincision surgery in the study group 4 was 80.00%(12/15),significantly higher than that in the study group 1(39.39%,13/33),with statistically significant difference(P<0.05).The average duration of preventive application rate of antibiotics for orthopedic typeⅠincision surgery in the study group 4 was 1.4 d,significantly shorter than 3.7 d in the study group 1,with statistically significant difference(P<0.05).In the study group 4,the indicators of medication indications,selection and course were significantly improved compared with the study group 1.CONCLUSIONS:Pharmaceutical comprehensive intervention can help to improve the level of rational drug use in orthopedics,reduce the overuse of antibiotics,and avoid the occur

关 键 词：Ⅰ类切口手术 抗菌药物 预防用药 骨科 

分 类 号：R978.1[医药卫生—药品]