谢燕如,祁俊华,叶常青,罗颖梅,莫智菲
XIE Yanru,QI Junhua,YE Changqing,LUO Yingmei,MO Zhifei

• 1:广州市妇女儿童医疗中心

摘要(Abstract)：

目的分析本院临床药师结合行政干预在改善外科围手术期使用抗菌药物和理性中的作用。方法采用回顾性方法,分别取本院在进行抗生素临床药师结合行政干预之前(2011-01~12)以及干预后(2013-01~12)的一段时间进行对比研究,在这两段时间内各随机抽取行手术治疗的患者1 000名(共2 000名),记录患者的使用抗生素的名称、类型、剂量、时机、频率、持续时间。对这两段时间内的抗生素合理性进行对比分析。结果本院外科围术期抗菌药物使用率非干预组为78.3%,联合用使用率为23.1%;干预组2项指标分别降至53.1%和8.9%(P<0.05);术前0.5~2 h内给药的比例由干预前的36.8%上升至干预后的85.8%(P<0.05);术后用药时间不超过24 h的非干预组为19.3%,而干预组为46.5%(P<0.05);非干预组抗菌药物合理使用率为0%,而干预组为72.3%,2组比较差异有统计学意义(P<0.05)。结论临床药师结合行政共同干预,可明显改善围术期使用抗菌药物的合理性。
OBJECTIVE To evaluate the rationality of antibiotic prophylaxis in pediatric surgical operation with the intervention of clinical pharmacists and administrative intervention period in the hospital. METHODS A total of 1 000 surgery cases( 2 000 surgery cases in total) were chosen before( during January to December in 2011) and after( during January to December in 2013) the intervention of clinical pharmacists with administrative intervention in the hospital. These cases were studied comparatively and retrospectively. The name,type,dosage,using time,times,duration and usage rationality of antibiotics were recorded. RESULTS After the intervention,the utilization rate of antibiotics decreased from 78.3% to 53.1%( P< 0.05),and the rate of drug combination usage decreased from 23.1% to 8.9%( P<0.05). The rate of preoperative administration( 0.5-2 h before surgical incision) increased from 36.8% to 85. 8%. The postoperative treatment time of 19. 3% cases in non-intervention group was less than 24 h,while in the intervention group was 46.5%( P< 0.05). The rational usage rate of antimicrobial drugs of non-intervention group was 0%,while the intervention group was 72.3%,and the difference between the 2 groups was statistically significant( P<0.05). CONCLUSION The intervention of clinical pharmacists with administrative intervention significantly improved antibiotics prophylaxis usage in operation.

关键词(KeyWords)： 围术期;抗菌药物;临床药师;行政干预;效果
perioperative period;antibiotics;clinical pharmacists;administrative intervention;effect

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 谢燕如,祁俊华,叶常青,罗颖梅,莫智菲
XIE Yanru,QI Junhua,YE Changqing,LUO Yingmei,MO Zhifei

参考文献(References)：

• [1]卫生部,国家中医药管理局,总后卫生部.抗菌药物临床应用指导原则[S].卫医发[2004]285号.
• [2]卫生部办公厅.关于抗菌药物临床应用管理有关问题的通知[Z].卫办医政发[2009]38号.
• [3]李玉欢,付学聪.临床药师干预普外科围手术期应用抗菌药物的临床效果及措施分析[J].山西医科大学学报,2014,45(7):631-633.
• [4]佟晓娜,陈伟,李灿霞,等.临床药师干预Ⅰ类切口围手术期预防使用抗菌药物效果分析[J].中国药业,2014,(21):76-78.
• [5]孙伟,胡必杰,高晓东,等.上海市2465例结直肠手术患者围手术期抗菌药物预防性应用现状调查[J].中华外科杂志,2014,52(11):831-833.
• [6]Usluer G,Ozgunes I,Leblebicioglu H.A multicenter point-prevalence study:antimicrobial prescription frequencies in hospitalized patients in Turkey[J].Ann Clin Microbiol Antimicrob,2005,4(1):16.
• [7]Rice LB,Feucht CL.An interventional program to improve antibiotic use[J].The annals of pharmacotherapy,2003,37(5).
• [8]夏玉菡.三种清洁手术围手术期预防使用抗菌药物调查分析[J].安徽医药,2013,17(4):695-696.