乳腺纤维瘤围手术期预防性抗菌药物的经济学评价

The Pharmacoeconomic Evaluations of Prophylactic Antibacterials in Perioperative Period of Mammary Gland Fibroma

目的对乳腺纤维瘤切除手术,围手术期预防性使用抗菌药物病例进行药物经济学研究,以促进临床合理用药。方法调查医院2009年1月至2010年12月,第一诊断为乳腺纤维瘤行乳腺切除术的110例病例,按照预防性使用抗菌药物的种类和时间分为4组。五水头孢唑林钠不大于24 h组(27例),五水头孢唑啉钠大于24 h组(30例),头孢硫脒不大于24 h组(25例),头孢硫脒大于24 h组(28例),并运用成本-效果分析法对其进行药物经济学评价。结果 4组预防有效率无显著性差异(P>0.05)。与不大于24 h组相比,五水头孢唑林钠大于24 h组有效率提高1个百分点所需的成本为697.00元,而头孢硫脒大于24 h组则需要364.21元;与头孢硫脒不大于24 h组相比,五水头孢唑林钠不大于24 h组有效率提高1个百分点所需成本为341.00元。结论药物经济学评价结果证明,术后24 h内停药为佳,头孢硫脒不大于24 h组为较佳预防用药方案。

Objective To research pharmacoeconomy of prophylactic antibacterials in perioperative period of mammary gland fibroma and improve clinic rational drug use. Methods The 110 cases of mastectomy patients with mammary gland fibroma were surveyed from January in 2009 to December in 2010. These patients were divided into four groups according to the kinds and time of prophylactic antibacterials： less than or equal to 24h group（27 cases） and exceeding 24 h group（30 cases） with cefazolin sodium pentahydrate,less than or equal to 24 h group（25 cases） and exceeding 24 h group（28 cases） with eefathiamidine. The method of pharmacoeeonomic evaluations was cost-effectiveness analysis. Results The prophylactic effective rates were no significant difference between four groups（ P 〉 0.05）.The cost of effective rate improving one percent respectively needed 697.00 yuan and 364.21 yuan of exceeding 24 h group with cefazolin sodium pentahydrate and cefathiamidine compared with less than or equal to 24 h group. The cost of effective rate improving one percent needed 341.00 yuan of less than or equal to 24 h group with cefazolin sodium pentahydrate compared with less than or equal to 24 h group with cefathiamidine. Conclusion The pharmacoeconomic evaluations proved that drug withdrawal less than or equal to 24 h after surgery was well and less than or equal to 24 h group with cefathiamidine was better schedule.