多部门联合干预胃癌围手术期预防性应用抗菌药物的效果分析  

Effect Analysis of Multi-Department Joint Intervention of Perioperative Prophylactic Application of Antibiotics for Gastric Cancer

作　　者：黄春燕[1] 尹颖 赵瑶[3] 王斌[4] 高杰[1] 于迪[1] HUANG Chunyan;YIN Ying;ZHAO Yao;WANG Bin;GAO Jie;YU Di(Dept.of Pharmacy,the First Affiliated Hospital of Soochow University,Jiangsu Suzhou 215006,China;Dept.of Medical Administration,the First Affiliated Hospital of Soochow University,Jiangsu Suzhou 215006,China;Infection Control Branch,the First Affiliated Hospital of Soochow University,Jiangsu Suzhou 215006,China;Dept.of General Surgery,the First Affiliated Hospital of Soochow University,Jiangsu Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院药学部,江苏苏州215006 [2]苏州大学附属第一医院医务处,江苏苏州215006 [3]苏州大学附属第一医院感染管理处,江苏苏州215006 [4]苏州大学附属第一医院普通外科,江苏苏州215006

出　　处：《中国医院用药评价与分析》2024年第5期623-626,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：国家临床重点专科(临床药学)建设项目(No.国卫办医函[2018]292号);江苏省医学重点学科(No.ZDXK202247);2022年度江苏省药学会-奥赛康医院药学科研基金项目(No.A202224)。

摘　　要：目的:探讨多部门联合干预对胃癌围手术期预防性应用抗菌药物的影响,为围手术期合理应用抗菌药物提供参考。方法:该院采用多部门联合干预胃癌围手术期预防性应用抗菌药物。比较干预前(2020年1月至2021年9月)104例、干预后(2021年10月至2022年9月)94例胃癌患者围手术期抗菌药物预防性使用情况及临床指标。结果:与干预前比较,干预后胃癌患者围手术期预防性使用抗菌药物的药物选择合理率从25.0%(26/104)提高至93.6%(88/94),联合用药率从73.1%(76/104)降低至1.1%(1/94);总用药时间从4.0(3.0,5.0)d缩短至3.0(3.0,3.0)d,其中总用药时间>48~72 h的患者占比42.3%(44/104)提高至81.9%(77/94),总用药时间>72 h的患者占比从55.8%(58/104)降低至13.8%(13/94);抗菌药物使用强度从21.3(16.8,31.7)DDDs/(100人·d)降低至14.5(12.6,18.7)DDDs/(100人·d);人均预防性应用抗菌药物总费用从184.5(126.7,887.4)元降低至134.6(95.4,168.3)元,上述差异均有统计学意义(P<0.05)。干预前后,术后手术部位感染率、其他感染率以及术后住院时间的差异均无统计学意义(P>0.05)。药师干预医嘱成功的病例数为42例,医师培训考核合格率为100%,科室抗菌药物考核达到要求。结论:通过多部门联合干预,可以有效提高胃癌围手术期预防性应用抗菌药物的合理性,并未对临床指标造成不利影响。OBJECTIVE:To explore the effect of multi-department joint intervention of perioperative prophylactic application of antibiotics for gastric cancer,so as to provide reference for the rational application of antibiotics in the perioperative period.METHODS:The hospital adopted multi-department joint intervention in the perioperative prophylactic application of antibiotics for gastric cancer.The prophylactic application of antibiotics in perioperative period and the clinical indicators of 104 cases with gastric cancer before intervention(from Jan.2020 to Sept.2021)and 94 cases with gastric cancer after intervention(from Oct.2021 to Sept.2022)were compared.RESULTS:Compared with before intervention,the rational rate of prophylactic application of antibiotics in perioperative period for gastric cancer patients after intervention increased from 25.0%(26/104)to 93.6%(88/94),and the rate of drug combination decreased from 73.1%(76/104)to 1.1%(1/94);the total duration of medication decreased from 4.0(3.0,5.0)d to 3.0(3.0,3.0)d,and the proportion of patients with total duration>48 to 72 h increased from 42.3%(44/104)to 81.9%(77/94),the proportion of patients with total duration of medication>72 h decreased from 55.8%(58/104)to 13.8%(13/94);the use intensity of antibiotics decreased from 21.3(16.8,31.7)DDDs/(100 people·d)to 14.5(12.6,18.7)DDDs/(100 people·d);the total cost per capita for prophylactic application of antibiotics decreased from 184.5(126.7,887.4)yuan to 134.6(95.4,168.3)yuan,the differences were statistically significant(P<0.05).There was no significant difference in postoperative surgical site infection rate,other infection rate and postoperative length of stay before and after intervention(P>0.05).The number of successful cases of intervention by pharmacists was 42,the qualified rate of training assessment in clinicians was 100%,and the examination of antibiotics in the department met the requirements.CONCLUSIONS:The rationality of perioperative prophylactic application of antibiotics in gastric cancer can b

关 键 词：胃癌 胃手术 抗菌药物 多部门联合干预 

分 类 号：R969.3[医药卫生—药理学] R978.1[医药卫生—药学]