围术期预防使用抗菌药物的信息化药学管理实践  

The Practice of Informationized Pharmaceutical Management of Perioperative Prophylactic Application of Antibiotics

作　　者：李秋雯 卢钧雄[1] 王若伦[1] 钟艺[1] LI Qiuwen;LU Junxiong;WANG Ruolun;ZHONG Yi(The Second Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong 510260,China)

机构地区：[1]广州医科大学附属第二医院药学部,广东广州510260

出　　处：《今日药学》2023年第1期65-68,共4页Pharmacy Today

基　　金：广东省医院药学研究基金(2020A25,2016M205)。

摘　　要：目的分析临床药师自主编码的合理用药干预系统在Ⅰ类和Ⅱ类切口手术围术期预防性使用抗菌药物的作用。方法临床药师在合理用药软件中对预防性使用抗菌药物的品种、时机、时长分别设定预警规则,触发预警的医嘱由药师二次审核,判定为问题医嘱即时发回主管医生予以改正。通过调查某院干预前3个月和干预后3个月的Ⅰ类和Ⅱ类切口手术病历,对比和评价药学干预对预防用药品种、时机及时长的影响。结果本次调查中Ⅰ类切口手术病历832例,其中干预前456例,预防用药86例(18.86%),干预后376例,预防用药50例(13.30%),干预后的Ⅰ类切口预防用药比例较之前小,差异具有统计学意义(P<0.05);Ⅱ类切口手术病历233例,其中干预前113例,预防用药98例(86.73%),干预后120例,预防用药102例(85.00%),干预前后预防用药比例对比差异无统计学意义(P>0.05)。术前有使用抗菌药物预防感染的病历336例,其中干预前184例,干预后152例。干预前预防用药品种合理率为88.04%,干预后为97.37%;干预前时机合理率为75.00%,干预后为87.50%;干预前预防用药平均时长为2.73 d,干预后为2.30 d。与干预前对比,干预后预防用药品种和时机合理率均明显升高,时长缩短,差异具有统计学意义(P<0.05)。结论临床药师构建的合理用药干预系统可有效促进围术期预防应用抗菌药物的合理使用。OBJECTIVE To analyze the role of rational drug use intervention system independently coded by clinical pharmacists in the perioperative prophylactic use of antibiotics in classⅠand classⅡincision surgery.METHODS The clinical pharmacist set early warning rules for the variety,timing and course of preventive use of antibiotics in the prescription automatic screening system.The doctor's orders that trigger the early warning were reviewed by the pharmacist twice.If the doctor's order was inappropriate,it would be sent back to the competent doctor for correction.The medical records of classⅠandⅡincisions in the hospital three months before and three months after the intervention were investigated,compared and evaluated the effects of pharmaceutical intervention on the variety,timing and course of preventive drugs.RESULTS In this investigation,there were 832 cases of classⅠincision surgery,including 456 cases before intervention and 86 cases(18.86%)used antibacterials,376 cases after intervention and 50 cases(13.30%)used antibacterials.The proportion of classⅠincision prophylaxis after intervention was smaller than that before,and the difference was statistically significant(P<0.05).There were 233 cases of classⅡincision surgery,including 113 cases before the intervention and 98 cases(86.73%)used antibacterials,120 cases after the intervention and 102 cases(85.00%)used antibacterials.There was no significant difference in the proportion of preventive drugs before and after the intervention(P>0.05).There were 336 cases of using antibiotics to prevent infection before operation,including 184 cases before intervention and 152 cases after intervention.The rational rate of preventive drugs was 88.04%before intervention and 97.37%after intervention.The reasonable timing rate before the intervention was 75.00%and 87.50%after the intervention.The average course of preventive medication before intervention was 2.73 days,and 2.30 days after intervention.Compared with that before intervention,the rational rate of va

关 键 词：围术期 抗菌药物 预防用药 

分 类 号：R954[医药卫生—药学]