国家基本药物和集中采购政策下术后颅内感染临床药径应用效果分析  

Clinical efficacy of medication routes for postoperative intracranial infections under the national essential drug and centralized procurement policies

作　　者：蔡楷柠 刘滔滔[1] 王思红 黄承龙 罗俊[1] 黄振光[1] 温燕[1] CAI Kaining;LIU Taotao;WANG Sihong;HUANG Chenglong;LUO Jun;HUANG Zhenguang;WEN Yan(Department of Pharmacy,The First Affiliated Hospital of Guangxi Medical University,Guangxi Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院药学部,广西南宁530021

出　　处：《中国医院药学杂志》2025年第4期455-461,共7页Chinese Journal of Hospital Pharmacy

基　　金：2023年度广西壮族自治区卫生健康委西医类自筹经费科研课题(编号:Z-A20230584);2023年国家卫生健康委医院管理研究所医疗质量(循证)管理研究项目(编号:YLZLXZ23K004)。

摘　　要：目的:评价基于国家基本药物和集中采购政策下,术后颅内感染患者应用临床药径管理后的效果,为药径在临床上的推广提供参考。方法:收集广西医科大学第一附属医院神经外科某病区2021年8月至2023年9月收治的298例确诊为术后颅内感染患者的病历,按照术后单纯颅内感染(下称“单纯感染组”)和术后颅内感染合并其他感染(下称“合并感染组”)进行病例分组分别统计,将临床药径实施前后的患者作为研究对象,运用SPSS 24.0软件进行数据分析,对比临床药径实施前后患者抗菌药物的使用情况、平均住院时间、次均住院费用等指标。结果:单纯感染组共纳入96例患者,合并感染组共纳入202例患者。临床药径实施后,2组患者的平均抗菌药物品种数分别降至2.75种和4.04种(P<0.05);基药和集采药使用品种次数占比分别提高至48.76%、58.68%和35.44%、65.69%;颅内感染的一线推荐用药,如万古霉素、美罗培南的使用频次占比上升。单纯感染组使用频次占比排名前5及合并感染组使用频次占比排名前15的基药/集采药种类在药径实施前后基本保持一致;2组患者非基药/集采药种类使用频次占比最大的药物在药径前后均为万古霉素。样本病区在药径实施前后的抗菌药物消耗量和使用强度差异均无统计学意义。药径实施后,2组患者的平均住院时间分别为17.57 d(P>0.05)和22.29 d(P<0.05);单纯感染组的住院总费用下降14.70%(P>0.05),药品费用、抗菌药物费用分别下降32.14%、28.02%(P<0.05);合并感染组的住院总费用、药品费用、抗菌药物费用分别下降17.38%、34.10%、42.90%(P<0.05)。结论:临床药径在规范用药方案、控制医疗费用、缓解患者经济负担方面成效显著。OBJECTIVE To evaluate the effect of medication routes for postoperative intracranial infections under the national essential drug and centralized procurement policies,so as to provide references for the promotion of medication routes.METHODS The medical records of 298 patients diagnosed with postoperative intracranial infection and admitted to the Neurosurgery Department in The First Affliated Hospital of Guangxi Medical University from August 2021 to September 2023 were collected.The patients were divided into two groups according to postoperative intracranial infection alone(simple infection group)and postoperative intracranial infection combined with other infections(co-infection group).SPSS24.0 software was used for data analysis.The use of antibiotics,average length of stay,average hospitalization costs and other indicators were compared before and after the implementation of medication routes.RESULTS A total of 96 patients were included in the simple infection group and 202 patients were included in the co-infection group.After the implementation of medication routes,the average number of antibacterial drugs in the two groups significantly decreased to 2.75 and 4.04,respectively(P<0.05).The proportion of national essential drugs increased to 48.76%and 58.68%;and the proportion of centrally purchased drugs increased to 35.44%and 65.69%,respectively.The proportion of the frequency of first-line recommended drugs for intracranial infection increased,such as vancomycin and meropenem.The top 5 most frequently used essential drugs/centrally purchased drugs in the simple infection group and the top 15 in the co-infection group were basically the same before and after the implementation of medication routes.Vancomycin was the dominant non-essential drug/centrally purchased drug in the two groups before and after the implementation of medication routes.There were no significant differences in the consumption of antibiotics and defined daily doses of antibiotics in the sample wards before and after the implementation

关 键 词：颅内感染 基本药物 集中采购 临床药径 

分 类 号：R977[医药卫生—药品]