头孢菌素类注射剂皮试的规范化管理及分析  

Standardized management and analysis of Skin Test for Cephalosporin Injections

作　　者：贺钰茹 谢沂宏 姜怡雯 钟燕 黄璐瑶 李小丝 张家兴[2] HE Yuru;XIE Yihong;JIANG Yiwen;ZHONG Yan;HUANG Luyao;LI Xiaosi;ZHANG Jiaxing(Dept.of Pharmacy,Hospital of Chengdu Office of People’s Government of Tibetan Autonomous Region,Chengdu 610041,China;Dept.of Pharmacy,Guizhou Provincial People’s Hospital,Guiyang 550002,China)

机构地区：[1]西藏自治区人民政府驻成都办事处医院药剂科,成都610041 [2]贵州省人民医院药剂科,贵阳550002

出　　处：《中国医院用药评价与分析》2023年第6期653-656,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：国家自然科学基金地区科学基金项目(No.72064004)。

摘　　要：目的:探讨西藏自治区人民政府驻成都办事处医院(以下简称“该院”)规范头孢菌素类注射剂皮试对临床抗菌药物使用合理性的影响及其经济学价值,为头孢菌素皮试的规范化管理提供参考和依据。方法:回顾性分析该院规范头孢菌素类注射剂皮试前后的皮试筛查情况、药物过敏情况和换药情况等数据,同时从药品费用、耗材费用和护理劳动时间等方面对规范头孢菌素皮试进行经济性研究。结果:该院规范头孢菌素皮试前,皮试率高达95.14%(2782/2924),皮试阳性率约为2.19%(61/2782),患者用药后的过敏反应发生率为0.34%(10/2924),其中包含0.03%(1/2924)危及生命的严重过敏反应。规范头孢菌素皮试后,皮试率降至15.84%(384/2424),皮试阳性率为3.91%(15/384),患者用药后的过敏反应发生率降至0.29%(7/2424),且均表现为Ⅰ度或Ⅱ度过敏反应。经济性方面,规范头孢菌素皮试后,患者角度的人均皮试成本下降70.64%(从29.50元降至8.66元),医疗机构角度的人均成本下降76.30%(从53.16元降至12.60元)。结论:不规范的头孢菌素皮试不仅不能预测过敏,还可能增加其他抗菌药物的滥用风险以及造成医务人员对过敏反应的忽视,也会给患者、医保和全社会带来不必要的经济负担。因此,规范头孢菌素皮试是有效保障医疗质量和安全的一项重要工作,亟待推进,同时也需要多部门共同参与、共同协作。OBJECTIVE:To analyze the effect and economic value of standardized cephalosporin injection skin test on the rationality of clinical use of antibiotics in Hospital of Chengdu Office of People’s Government of Tibetan Autonomous Region(hereinafter referred to as“the hospital”),so as to provide reference and basis for the standardized management of skin tests of cephalosporin.METHODS:Data of skin test screening,drug allergy and dressing change before and after standardized skin test for cephalosporin injection were retrospectively analyzed.Meanwhile,the economic study of standardized skin test for cephalosporin injection was carried out from the aspects of drug cost,consumable cost and nursing labor time.RESULTS:Before the standardized cephalosporin injection skin test in the hospital,the rate of skin test was as up to 95.14%(2782/2924),the positive rate of skin test was about 2.19%(61/2782),and the incidence of allergic reaction in patients was 0.34%(10/2924),including 0.03%(1/2924)incidence of life-threatening severe allergic reactions.After standardizing cephalosporin skin test,the rate of skin test decreased to 15.84%(384/2424),the positive rate of skin test was 3.91%(15/384),the incidence of allergic reaction decreased to 0.29%(7/2424),and all patients showed gradeⅠorⅡallergic reactions.In terms of economy,after standardizing cephalosporin skin test,the per capita cost of skin test from the perspective of patients decreased by 70.64%(from 29.50 yuan to 8.66 yuan),and the per capita cost from the perspective of medical institutions decreased by 76.30%(from 53.16 yuan to 12.60 yuan).CONCLUSIONS:Non-standard cephalosporin skin test not only cannot predict allergy,but may increase the risk of abuse of other antibiotics and lead to the neglect of allergic reactions by medical staff,and also bring unnecessary economic burden to patients,medical insurance and the whole society.

关 键 词：头孢菌素 皮试 合理用药 药物经济学 

分 类 号：R978.1[医药卫生—药品]