临床药师干预结直肠手术患者围术期抗菌药物应用的效果评价

Evaluation of Clinical Pharmacist Intervention Application of Antibiotics in Perioperative Period of Colorectal Operation Effect

目的:回顾性分析和评价临床药师干预在结直肠手术患者围手术期抗菌药物应用的效果。方法:随机抽取我院2011年3月至2012年2月间行结直肠手术患者120例列入对照组,未实施临床药师干预用药;2012年3月至2013年2月间患者120例列入研究组,实施临床药师干预用药。调取所有受试者病例资料分析用药品种和用药合理性情况,并行两组间比较。结果:研究组经临床药师干预后,氨基糖苷类单用或联合用药的比例较对照组明显下降(P<0.05),氟喹诺酮类用药和β-内酰胺酶抑制剂研究组不再使用,与对照组差异具有显著性(P<0.05)。研究组干预前用药时间(术前、术后)不合适的比例较高,干预后即明显降低(P<0.01),药物品种选择不当、换用药品无明确依据、药品联用不适宜、和给药途径不适宜等指标干预后也有明显下降(P<0.05)。结论:结直肠手术患者围手术期在临床药师的指导干预下应用抗菌药预防感染有利于更好的执行相关文件的要求,有效提高抗菌药用药合理性,减少滥用,具有可行性、实用性、有效性和安全性。

Objective：To retrospective analysis and evaluation of clinical pharmacist interventions in colorectal operation effect of antimicrobial application in patients during operation period. Methods：Randomly selected in our hospital from 2011 March to 2012 February 120 cases of patients with colorectal operation included in the control group, the clinical pharmacists intervention use not the implementation of 2012 March to 2013 February;120 patients included in the study group, the implementation of clinical pharmacists in drug intervention. Access to all subjects were analyzed and the rational use of drugs, parallel comparison between the two groups. Results：The study group by clinical pharmacist intervention, aminoglycoside monotherapy or combination ratio decreased significantly compared with the control group （P〈0.05）, a fluoroquinolone drugs and beta-lactamase inhibitor study group is no longer used, and the control group with significant difference （P〈0.05）. Study group before the intervention time of medication （preoperative, postoperative） ratio is not suitable high, after the intervention significantly reduced （P〈0.01）, drug varieties improper selection, with no clear evidence of drug, drug combination is not suitable, and the route of administration is not suitable index has obviously dropped after intervention （P〈0.05）. Conclusion：Colorectal operation patients during operation period in the intervention of clinical pharmacists under application of antibiotics to prevent infection with implementation of the relevant documents to facilitate better requirements, effectively improve the use of antibacterial drug reasonable, reduce misuse, feasibility, practicality, effectiveness and safety.