外科围术期预防性应用抗菌药物调查及药物经济学研究

Perioperative Utilization of Prophylactic Antibacterials and Pharmacoeconomic Study

目的:了解外科围术期抗菌药物预防性使用情况,促进临床合理用药,降低医疗费用。方法:采用回顾性调查方法,对456例外科围术期患者应用抗菌药物的情况进行回顾性分析,采用成本-效果分析方法进行评价。结果:456例患者中,Ⅰ类切口手术208例,Ⅱ类切口手术242例,Ⅲ类切口手术6例;切口愈合率分别为甲级98.68%、乙级1.1%、丙级0.22%;抗菌药物总使用率为97.81%(446例),人均抗菌药物费用为948.5元,由于不合理使用抗菌药物而多支出药品费用达到人均334.76元。结论:外科围术期在抗菌药物种类选择、用药时机和持续用药时间等方面仍存在不合理现象,从而导致医疗费用的增加。

OBJECTIVE： To investigate the perioperative application of prophylactic antibacterials in surgical department to promote clinical rational drug use and lower medical cost. METHODS： The perioperative utilization of prophylactic antibacterials in a total of 456 surgical patients was investigated retrospectively and evaluated by using cost-effectiveness analysis. RESULTS ： Of the total 456 cases, the patients with type I, II and III incisions were 208, 242 and 6 cases, respectively. The wound healing rates of grade A, C and C were 98.68% , 1.1% and 0.22% , respectively. 446 cases （97.81% ） received antibacterials, and the average cost of antibacterials per capita was 948.5 Yuan, with unnecessary cost of 334.76 Yuan per capita caused by irrational use of antihacterials. CONCLUSION ： The perioperaitve utilization of prophylactic antibacterials is somewhat irrational in the choice of variety, medication occasion and medication duration etc, which leads to increased medical cost.