Ⅰ、Ⅱ类切口围手术期抗菌药物合理应用的干预对照研究

Study on intervention and comparison of rational use of antibiotics on perioperative period of clean incision and clean-defiled incision

目的 探讨围手术期抗菌药物应用的评价与干预措施实施的可行性。方法 选取两家三级甲等医院 ,分设干预组、非干预组 ,对干预前后同期出院的甲状腺、乳腺、腹腔镜胆囊切除术、经腹子宫肌瘤和子宫肌瘤 +附件手术病例 ,进行干预对照研究。结果 干预后干预组平均药费由16 0 1.2 7元下降为 14 89.5 9元、抗菌药平均费用由 74 0 .2 0元下降为 35 2 .0 3元 (P <0 .0 1) ;使用抗菌药物的合理率 (合理 +基本合理 )有显著提高 ,由干预前的 31.35 %上升为干预后的 91.81% (P <0 .0 1)。结论 实施的合理用药措施具有可行性和有效性 ,对促进安全、有效。

Objective To explore a set of scientific evaluation and intervention methods on perioperatur period which fits for China's situation, and to promote the development of rational drug use. Methods Two would tertiary general hospitals were selected and separated in to intervention group and control group. Intervention was carried out and compared at the same period on inpatient surgical cases of thryroidectomy, mastectomy, cholescystectomy, and hysteromyomectomy plus appendix. Results The average drug costs was decreased from 1 601.27 yuan to 1 489.59 yuan and the average antibiotics use from 740.20 yuan to 352.03 yuan ( P < 0.01 ) in the intervention group pre and post intervention. There was a remarkable improvement on the rationality of antibiotics use in intervention group, from 31.35 % to 91.81 % ( P < 0.01 ) pre and post intervention, implemented in the hospital. Conclution It is practicable and effective to implement rational drug use where intervention was carried out, since it plays an active role on promoting safely, effectively and economic antibiotic use in China.