医疗机构头孢菌素类抗菌药物皮试规范化管理  

Standardized management of cephalosporin skin test in medical institutions

作　　者：陈相军[1] 周益[1] 孟娟[1] 刘焱斌[1] 管玫[1] 蒋艳[1] 李大江[1] 曾勇[1] 陈敏[1] 吕晓菊[1] Chen Xiang-jun;Zhou Yi;Meng Juan;Liu Yan-bin;Guan Mei;Jiang Yan;Li Da-jiang;Zeng Yong;Chen Min;LV Xiao-ju(West China Hospital,Sichuan University,Chengdu 610041)

机构地区：[1]四川大学华西医院,成都610041

出　　处：《中国抗生素杂志》2021年第12期1133-1137,共5页Chinese Journal of Antibiotics

基　　金：成都市技术创新研发项目(No.2020-YF05-00244-SN)。

摘　　要：目的探讨取消常规头孢菌素皮试的规范化管理和成效。方法制定我院常规头孢菌素皮试操作规范、严重过敏反应抢救流程及严重过敏反应抢救标准操作规范。回顾性分析2020年1月—2020年11月和2019年1月—2019年11月我院头孢菌素皮试相关数据以及药品不良反应发生情况。结果我院头孢菌素皮试人次显著下降,2020年1月—2020年11月头孢菌素皮试人次数仅为1969人次,明显低于2019年同期。2020年进行头孢菌素皮试的主要原因包括:①部分医生仍存在一定疑虑(1808,91.82%);②患者对是否有头孢菌素过敏史作出模糊回答(32,1.63%);③患者要求头孢菌素皮试(67,3.40%);④其他原因(62,3.15%)。头孢菌素类抗菌药物次均费用明显下降,有统计学差异(t=37.23,P<0.05)。因直接使用头孢菌素类抗菌药物导致药品不良反应事件无统计学差异,取消头孢菌素皮试前后皮试阳性率结果有差异。结论规范化管理常规头孢菌素皮试,不仅显著降低头孢菌素皮试人次数和医疗费用,也有效保证了医疗质量与安全。Objective To investigate standardized management and efficiency of abolishing routine cephalosporin skin tests in our hospital.Methods We enacted the operation norm of routine cephalosporin skin tests,salvage process of serious anaphylactic reaction and standard operation norm of serious anaphylactic reaction salvage.A retrospective analysis was conducted with the clinical data of cephalosporin skin tests and adverse drug reaction between Jan 2020 to Nov 2020 and same period of 2019.Results Person times of cephalosporin skin tests were reduced significantly,which were 1969 in the period of Jan 2019 to Nov 2019 and were lowered than those in the period of Jan 2019 to Nov 2019.The main reasons included that parts of doctors had a certain extent of misgivings for cephalosporin skin tests(1808,91.82%),the patients gave some vague answers about their cephalosporin allergy history(32,1.63%),the patients required the cephalosporin skin test(67,3.40%),and others(62,3.15%).The cost was significantly reduced between Jan to Nov 2020 and some period of 2019(t=37.23,P<0.05).Meanwhile,there were no statistically significant differences in adverse drug reaction events between Jan to Nov 2020 and some period of 2019,but an opposite result existed in the positive rate of cephalosporin skin tests.Conclusion Based on standardized management,the patients of routine cephalosporin skin tests and cost were not only reduced significantly,but also the medical quality and safety was ensured effectively.

关 键 词：头孢菌素 皮试 规范管理 

分 类 号：R978.1[医药卫生—药品]