临床药师介入对老年结直肠癌患者围术期使用抗菌药物合理性的影响  

Influence of clinical pharmacist intervention on the rational use of perioperative antibiotics among elderly patients with colorectal cancer

作　　者：刘娟[1] 苏凤娟 卢妍全 刘沙[1] 黄丹[1] 徐中良[1] LIU Juan;SU Feng-juan;LU Yan-quan(Pharmacy Department,Yongchuan Hospital Affiliated to Chongqing Medical University,Chongqing 402160,China.;不详)

机构地区：[1]重庆医科大学附属永川医院药学部,重庆402160

出　　处：《医师在线》2024年第8期73-76,共4页Journal of Doctors Online

基　　金：重庆市教育委员会科学技术研究项目(KJQN202100433);重庆市永川区科技局自然科学项目(2023yc-jckx20047)。

摘　　要：目的探究临床药师介入对老年结直肠癌患者围术期使用抗菌药物合理性的影响。方法选取2023年1月1日~2023年12月31日我院收治的老年结直肠癌手术患者110例,按照随机数字表法分为对照组和观察组,各55例。其中,对照组采用常规抗菌药物治疗;观察组在常规抗菌药物治疗的基础上由临床药师介入用药干预。对比两组患者抗菌药物的用药品种、抗菌药物使用的合理性、术后切口疼痛程度、用药指标及术后感染发生率。结果观察组氨基糖苷类、β-内酰胺酶抑制剂、β-内酰胺酶抑制剂+硝基咪唑类抗菌药物的使用率明显低于对照组(P<0.05),第2代头孢类、第3代头孢类、氨基糖苷类+硝基咪唑类、第2代头孢类+硝基咪唑类、第3代头孢类+硝基咪唑类抗菌药物的使用率明显高于对照组(P<0.05);观察组发生抗菌药物不合理用药的情况少于对照组(P<0.05);观察组的视觉模拟评分法(VAS)评分及抗菌药物花费低于对照组,抗菌药物用药疗程及住院时间短于对照组(P<0.05);观察组术后切口感染、尿路感染及呼吸道感染的发生率均低于对照组(P<0.05)。结论临床药师干预可提高围术期老年结直肠癌患者抗菌药物使用的合理性,减少临床不合理用药,降低术后感染率和疼痛感,有利于患者康复。Objective To explore the influence of clinical pharmacist intervention on the rational use of perioperative antibiotics among elderly patients with colorectal cancer.Methods A total of 110 elderly patients with colorectal cancer surgery admitted to our hospital from January 1,2023 to December 31,2023 were selected and divided into control group and observation group(55 cases each)according to random number table method.The control group was treated with conventional antibiotics,and the observation group was intervened by clinical pharmacists on the basis of routine antimicrobial therapy.Compare the types of antibiotics used,the rationality of the use of antibiotics,the degree of postoperative incision pain,clinical indicators,and infection incidence between the two groups.Results The application rates of aminoglycosides,β-Lactamase inhibitors,β-lactamase inhibitors,β-lactamase inhibitors+nitroimidazoles in the observation group were significantly lower than control group(P<0.05).The application rates of second-generation cephalosporins,third-generation cephalosporins,aminoglycosides+nitroimidazole antibiotics,second-generation cephalosporins+nitroimidazole,third-generation cephalosporins+nitroimidazole were significantly higher than control group(P<0.05).The incidence of irrational use of antibiotics in the observation group was lower than control group(P<0.05).The visual analog scale(VAS)score and the cost of antibiotics in the observation group were lower than control group,and the application time and hospitalization time were shorter than those in the control group(P<0.05).The incidence of incision infection,urinary tract infection,and respiratory tract infection in the observation group were lower than those in the control group(P<0.05).Conclusion In the perioperative period of elderly patients with colorectal cancer,clinical pharmacists intervention can improve rational use of antibiotics,reduce clinical irrational drug use,reduce postoperative infection rates and pain,and facilitate patient recovery.

关 键 词：临床药师 结直肠癌 围术期 抗菌药物 合理用药 

分 类 号：R735.3[医药卫生—肿瘤]