基于加速康复外科理念的妇科恶性肿瘤围术期药学服务模式构建及实践  

Construction and Practice of ERAS-Based Pharmaceutical Care Model for the Patients in the Perioperative Period of Gynecological Malignant Tumor Surgery

作　　者：王柯静[1] 郑丹 孙玉菡[1] 代玲[1] 陈琳[1] WANG Kejing;ZHENG Dan;SUN Yuhan;DAI Ling;CHEN Lin(Chongqing Health Center for Women and Children,Chongqing,China 401147)

机构地区：[1]重庆市妇幼保健院,重庆401147

出　　处：《中国药业》2021年第10期12-16,共5页China Pharmaceuticals

基　　金：重庆市卫生计生委医学科研项目[2017MSXM110]。

摘　　要：目的构建妇科恶性肿瘤围术期规范化药学服务模式。方法选取医院2019年拟行妇科恶性肿瘤手术的患者140例,随机分为研究组和对照组,各70例。研究组患者给予以加速康复外科(ERAS)为基础的药学服务模式,对照组患者给予常规药学服务模式。比较两组患者术后并发症、用药差错发生率,药品不良反应处置率,诊疗费用,住院时间,镇痛效果和抗菌药物使用情况,并分析临床药师提供药学服务的情况。结果与对照组比较,研究组患者术后发热、腹胀、恶心呕吐和用药差错发生率及镇痛效果评分均明显降低,诊疗费用和抗菌药物费用明显减少,抗菌药物疗程和住院时间明显缩短,获得药学查房及用药方案制订和优化的次数,用药教育频率,用药监护率和药物重整率明显升高(P<0.05)。结论以ERAS为基础的围术期药学服务模式的建立与实施,有利于将药物治疗监管和药师工作融入ERAS围术期管理体系,确保患者能获得规范化、同质化、全程化的药学服务。Objective To establish a standardized pharmaceutical care model for the patients in the perioperative period of gynecological malignant tumor surgery.Methods A total of 140 patients who would undergo gynecological malignant tumor surgery in our hospital in2019 were selected and randomly divided into the study group and the control group,70 cases in each group.The patients in the study group were given the enhanced recovery after surgery(ERAS)-based pharmaceutical care model,while the patients in the control group were given the conventional pharmaceutical care model.The incidence of postoperative complications and medication errors,the disposal rate of adverse drug reactions,diagnosis and treatment cost,length of stay,analgesic effect and use of antibiotics were compared between the two groups,and the pharmaceutical care provided by clinical pharmacists was analyzed.Results Compared with those in the control group,the incidence of postoperative fever,abdominal distension,nausea and vomiting and medication errors,the score of analgesic effect in the study group were significantly reduced,the cost of diagnosis and treatment and the cost of antibiotics in the study group were significantly reduced,the course of treatment with antibiotics and length of stay were significantly shortened,while the pharmacy rounds(times/person),formulation and optimization of medication plan(times/person),medication education(times/person),the rate of medication monitoring and drug reforming in the study group were significantly increased(P<0.05).Conclusion The establishment and implementation of the ERAS-based perioperative pharmaceutical care model are conducive to integrating drug therapy supervision and pharmacist work into the ERAS-based perioperative management system,ensuring that patients can receive standardized,homogeneous and whole-process pharmacy care.

关 键 词：临床药师 加速康复外科 妇科恶性肿瘤 围术期 药学服务模式 

分 类 号：R95[医药卫生—药学]