药学服务对骨科Ⅰ类切口手术预防用抗菌药物干预效果研究

Study of intervention effect of usage of antibacterials to orthopedics type Ⅰ operation cuts of pharmaceutical care

目的探讨药学服务对骨科Ⅰ类切口手术预防用抗菌药物的干预途径,规范医院骨科Ⅰ类切口手术围术期抗菌药物预防性应用与管理。方法选择我院骨科Ⅰ类切口手术患者100例作为观察组,另选择我院同期不接受干预的骨科Ⅰ类切口手术患者100例设为对照组,研究药学服务预防性应用抗菌药物合理性,并对选用的抗菌药物品种、用程、用药频度、联合用药等方面进行了统计、对比与评价。结果①与对照组比较,观察组硝基咪唑类、第3代头孢、林可酰胺类使用频次较低,而大环内酯类、第1代头孢使用频次明显较高;②观察组单用药使用频次较高,联合用药使用频次明显较低,与对照组比较差异有统计学意义(P<0.05);③观察组非限制级抗菌药物应用频次明显提高,限制及特殊级抗菌药频次下降,与对照组比较差异有统计学意义(P<0.05);④两组预防用药时间比较差异有统计学意义(t=6.29,P<0.05),观察组住院的各项费用与对照组比较明显较低(P<0.05);⑤接受药学服务预防性应用抗菌药物后合理用药比例明显高于对照组,差异有统计学意义(P<0.05)。结论恰当的药学服务措施能有效提高医院Ⅰ类切口手术围术期预防性应用抗菌药物的合理水平。

Objective To investigate the intervention method of usage of antibacterials to orthopedics type Ⅰ operation cuts by pharmaceutical care.To regulate the preventive application and management of antibacterials on orthopedics type Ⅰ operation cuts.Methods 100 patients with orthopedics type Ⅰ operation cuts were selected in our hospital.Other 100 ones were control group without therapeutic intervention at the same time.The rationality of preventive usage of antibacterials was studied on pharmaceutical care,and the species,degree,frequency and combination of antibacterial drugs which were chosen had been compared and evaluated.Results ①Compared to the controls,the application frequencies of nitromidazoles,thirdgeneration cephalosporins and lincosamides were lower,whereas the frequencies of macrolides and firstgeneration cephalosporins were higher in observation group.②The frequency of single dose was higher,well that of combination was lower than that in control group（P〈0.05）.③Compared to the controls,the frequencies of nonrestricted antibacterials were higher,but that of restricted and special antibiotic were lower,it had statistical difference（P〈0.05）.④The average time of preventive medication between two groups had significance（t = 6.29,P〈0.05）.The hospitalization expenses of observation were lower than it in controls（P〈0.05）.⑤The proportion of rational drug use after preventive usage of antibacterials of pharmaceutical care in observation group was remarkable higher than that in controls（P〈0.05）.Conclusion Proper pharmaceutical care can effectively improve the rationality level of preventive application of antibacterials on type Ⅰ operation cuts at perioperative period.