不同管理措施对泌尿外科Ⅱ类切口手术围手术期药物使用合理性的改善效果研究  

Improvement Effects of Different Management Measures on Rational Use of Perioperative Drugs in Urology ClassⅡIncision Surgery

作　　者：张彦[1] 虞勋[1] 陈世祺[1] 杭永付[1] 朱建国[1] ZHANG Yan;YU Xun;CHEN Shiqi;HANG Yongfu;ZHU Jianguo(Dept.of Pharmacy,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

出　　处：《中国医院用药评价与分析》2025年第3期368-371,375,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：江苏省医学重点学科(No.ZDXK202247)。

摘　　要：目的:探讨不同管理措施对该院泌尿外科Ⅱ类切口手术围手术期5类药物(抗菌药物、质子泵抑制剂、止吐药、止血药和镇痛药)使用合理性的改善效果,促进Ⅱ类切口手术围手术期用药合理。方法:强化药师在合理用药管理中的作用,在处方点评管理措施上,引入中心审方和用药干预,形成事前、事中、事后合理用药的全流程管理,并评估单联、双联、三联管理措施下,泌尿外科Ⅱ类切口手术围手术期药物使用各类指标的改善情况。结果:共纳入2020—2023年该院泌尿外科行前列腺相关手术治疗的Ⅱ类切口手术男性患者460例,其中实施单一管理措施152例、双联管理措施155例、三联管理措施153例。2020—2023年,纳入病例的平均住院总费用无明显增长,而平均药品费用降低57.80%[从2020年的(4329.23±1761.53)元降至2023年的(1826.78±872.77)元],平均住院时间减少17.56%[由2020年的(11.90±3.20)d减少至2023年的(9.81±2.41)d];平均抗菌药物使用强度降低46.58%[从2020年的(40.30±16.80)DDDs/(100人·d)降至2023年的(21.53±15.99)DDDs/(100人·d)]。围手术期5类药物中,除抗菌药物、止血药外,其余药物的使用率逐年降低;除镇痛药外,其余药物的使用合理率明显改善;其中三联管理措施的改善效果较双联管理措施、单一管理措施更快、更明显,且成效持久;而单一管理措施下药物使用合理率出现波动或下降的现象。结论:药师可在促进合理用药管理中发挥重要作用,其主导的综合管理措施较单一管理措施成效更明显,值得进一步推广应用。OBJECTIVE:To probe into the improvement effects of different management measures on rational use of 5 categories of drugs(antibiotics,proton pump inhibitors,antiemetics,hemostatics and analgesics)in perioperative period of urology classⅡincision surgery in the hospital,and to promote rational medication in perioperative period of classⅡincision surgery.METHODS:Role of pharmacists in rational medication management was strengthened,centralized prescription review and medication intervention for prescription review management measures were introduced to form a whole-process management of before-during-after rational medication,and the improvement effects of various indicators of medication in perioperative period of urology classⅡincision surgery were evaluated under single,double and triple management measures.RESULTS:A total of 460 male patients with classⅡincision surgery who underwent prostate-related surgical treatment in the urology department in the hospital from 2020 to 2023 were enrolled,of which 152 cases were implemented with single-link management measures,155 cases with double-link management measures,and 153 cases with triple-link management measures.From 2020 to 2023,the average hospitalization cost of the enrolled cases did not increase significantly,while the average drug cost decreased by 57.80%[from(4329.23±1761.53)RMB in 2020 to(1826.78±872.77)RMB in 2023],the average length of stay decreased by 17.56%[from(11.90±3.20)d in 2020 to(9.81±2.41)d in 2023],and the average antibiotics use density decreased by 46.58%[from(40.30±16.80)DDDs/(100 person·d)in 2020 to(21.53±15.99)DDDs/(100 person·d)in 2023].Among 5 categories of drugs in perioperative period,except for antibiotics and hemostatics,the usage rates of other drugs decreased year by year,and except for analgesics,the rational rate of other drugs were improved significantly,in which the improvement effect of triple management measures was faster and more obvious than those of double management measures and single management measure

关 键 词：Ⅱ类切口 围手术期 合理用药 

分 类 号：R969.3[医药卫生—药理学] R97[医药卫生—药学]