叶青,杜婉桃,朱少惠
YE Qing,DU Wantao,ZHU Shaohui

• 1:佛山市南海区第四人民医院

摘要(Abstract)：

目的某院临床药师于2015年开始直接参与Ⅰ类切口手术术前讨论,对围手术期抗菌用药提出建议,通过对比药学干预前后抗菌药物的使用情况,观察干预效果。方法采用回顾性方法选择2014年(药学干预前)和2015年(药学干预后)某院骨外科闭合性骨折修复Ⅰ类切口手术各112例,比较干预前后预防用药的比例、用药的时长、药物使用的种类以及药品费用。结果药学干预后预防用药率从83.93%降至20.54%;用药时机术前0.5~2 h控制率为100%;术后用药时长超过24 h从78.57%降至9.82%;病人抗菌药费同比下降57.76%。结论该院Ⅰ类切口手术抗菌药物药学干预措施切实可行,减少病人药费支出的同时降低因滥用或长时间使用抗菌药物产生的细菌耐药性。
OBJECTIVE Clinical pharmacists have involved directly in the pre-surgical discussion for type Ⅰ incision surgery in a hospital since 2015,in order to provide suggestions for antibacterial drug use during the pre-surgical period.The improvement of antibacterial drug use is compared before and after the pharmaceutical intervention,so as to observe effects of the intervention.METHODS Closed fracture repair patients with type Ⅰ incision surgery were enrolled retrospectively in the Orthopeadics Surgery Department of the hospital,with 112 patients in 2014(before the pharmaceutical intervention) and 112 patients in 2015(after the pharmaceutical intervention);the proportion and length of preventive medication,the kind of drug use and the drug expense were compared before and after the intervention.RESULTS After the pharmaceutical intervention,the preventive medication rate reduced from 83.93% to 20.54%;the control rate was 100% for administration occasion 0.5-2 hours before surgery;the length of drug use >24 hours diminished from 78.57% to 9.82% after surgery;the antibiotics drug expenses of patients dropped by 57.76% than before.CONCLUSION The pharmaceutical intervention measures of antibacterial drugs for typeⅠincision surgery in the hospital are feasible and practical,obtaining clinical success.It can reduce drug expenses of patients and bacterial drug resistance caused by the abuse and long-term use of antibacterial drugs as well.

关键词(KeyWords)： Ⅰ类切口手术;抗菌药物;药学干预
type Ⅰ incision;antibiotics;pharmaceutical intervention

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 叶青,杜婉桃,朱少惠
YE Qing,DU Wantao,ZHU Shaohui

参考文献(References)：

• [1]《抗菌药物临床应用指导原则》修订工作组.抗菌药物临床应用指导原则:2015年版[M].北京:人民卫生出版社,2015.
• [2]中华医学会外科学分会.围手术期预防应用抗菌药物指南[J].中华外科杂志,2006,44(23):1594-1596.
• [3]高宁舟,沈杰,周海峰,等.Ⅰ类切口手术围术期抗菌药物应用干预480例结果分析[J].中国抗生素杂志,2014,39(1):77-81.
• [4]闫抗抗,常捷,杨才君,等.Ⅰ类切口手术预防使用抗菌药物的研究进展[J].中国药房,2016,27(26):3736-3738.
• [5]李锐,王一兵,王翠翠,等.清洁手术预防使用抗菌药物的调查与评价[J].中国感染控制杂志,2016,15(7):511-514.
• [6]魏静,孙晓娈,陈婉琦,等.临床药师干预骨折内固定装置取出术预防使用抗菌药物的效果评价与分析[J].中国药房,2017,28(14):1994-1998.
• [7]艾伟鹏,吕小娟,马林,等.规范使用抗菌药对预防Ⅰ类切口手术部位感染的效果评价[J].中国药师,2014,17(4):644-646.
• [8]刘小芹,周淑英,黄荣海.处方点评干预前后某院住院患者抗菌药物使用的对照分析[J].今日药学,2015,25(8):591-594.
• [9]王飞,张丹晔,张秀月,等.国内外手术部位感染相关研究综述[J].现代预防医学,2012,39(22):5972-5974.
• [10]卓霞,阚燕,闽鹏.骨科Ⅰ类切口手术抗菌药物预防使用干预效果研究[J].中国抗生素杂志,2013,38(10):799-800.
• [11]刘子昀,刘冬,张晓钰,等.专项整治前后Ⅰ类切口手术预防用抗菌药物对比分析[J].中国医药导报,2014,11(17):134-138.
• [12]雷国强.专项整治前后某院普外科Ⅰ类切口围术期预防使用抗菌药物分析[J].今日药学,2015,25(5):366-368.
• [13]沈毅,顾申勇,谢宁,等.我院5种Ⅰ类切口手术围手术期预防用抗菌药物调查分析[J].中国药业,2012,21(17):37-38.
• [14]缪玉秀,高焕新,廖友芝.外科手术部位感染目标性监测对抗生素合理使用的影响[J].护理学杂志,2012,27(2):77-79.
• [15]吕建平,黄志芬,李琳红,等.药师干预剖宫产围术期合理应用抗菌药物的对照研究[J].广东药学院学报,2012,28(2):176-179.