临床药师干预前后腹腔镜胆囊切除术围术期预防用抗菌药的使用评价

Effect Evaluation of Intervention on Prophylactic Antibiotics in Laparoscopic Cholecystectomy by Clinical Pharmacist

目的：调查某院实施干预前后腹腔镜胆囊切除术预防用抗菌药（简称＂预防用药＂）的应用情况,为临床合理预防用药提供参考。方法：分别抽取2013年5～6月和2014年5～6月行腹腔镜胆囊切除术患者,分别纳入干预前组（n=80）和干预后组（n=76）,对两组患者的预防用药情况进行统计分析。结果：实施干预后,预防用药率由干预前的100%降至19.7%,预防用药的选药合理率由干预前的12.5%升至73.3%,预防用药时间由干预前的（3.2±0.9）d缩短至（2.1±0.9）d,差异均有统计学意义（P〈0.01）。术后感染发生率无明显变化。结论：该院临床药师干预措施得力,干预效果显著,明显促进了腹腔镜胆囊切除术围术期预防用药合理性。

Objective： To evaluate the effect of clinical pharmacists throughout interventing on prophylactic antibiotics in laparoscopic cholecystectomy and to provide reference to clinical antibacterial application in perioperative period. Methods： Eighty cases of discharged patients underwent laparoscopic eholecystectomy from May 2013 to June 2013 and 76 cases of discharged patients underwent laparoscopic cholecystectomy from May 2014 to June 2014 were divided into non-intervention group and intervention group, respectively. The rationality of prophylactic antibiotics was compared before and after intervention. Results ： After intervention, the rates of prophylactic application were decreased significantly from 100% before interention to 19.7% （P 〈 0.01 ） ; The rationality rate of prophylactic application was improved significantly from 12.5% before intervention to 73.3% （ P 〈 0.01 ） ; The course of preventive medication treatment decreased significantly from （3.2± 0.9 ） days to （ 2.1± 0.9 ） days （ P 〈 0.01 ） . There was no significant difference in postoperative infection rate among the two groups. Conclusion：The pharmaceutical intervention by clinical pharmacist of our hospital is feasible and valid to improve rational use of prophylactic antibiotics in laparoscopic cholecystectomy.