慢性胆囊炎单病种临床路径使用抗菌药物的疗效与药物经济学评价

Curative Effect and Cost-effectiveness Analysis of Antimicrobial Agents for Chronic Cholecystitis Single Disease Clinical Pathway

目的:探讨慢性胆囊炎单病种临床路径预防性使用不同抗菌药物以及不预防性使用抗菌药物在预防感染方面的疗效与药物经济学评价。方法:对预防性使用频率较高的3种抗菌药物(头孢呋辛、头孢替安、头孢西丁)以及不预防性使用抗菌药物的380例诊断为慢性胆囊炎或合并胆囊结石行腹腔镜胆囊切除术并实行慢性胆囊炎临床路径的患者病历进行回顾性分析,比较其疗效,并运用成本-效果分析进行药物经济学评价。结果:4种方案取得的疗效相同,未用抗菌药物组、头孢呋辛组患者的成本-效果比低于头孢替安组、头孢西丁组。结论:慢性胆囊炎单病种临床路径不预防性使用抗菌药物或预防性使用头孢呋辛是较佳方案。

OBJECTIVE：To evaluate the curative efficacy and pharmacoeconomics of prophylactic antibiotics in the prevention of infections in patients with chronic cholecystitis single disease clinical path .METHODS： The medical records of a total of 380 patients with chronic cholecystitis and （ or） gallstones undergoing cholecystectomy and clinical pathway receiving three common prophylactic antibiotics （cefuroxime, cefotiam, cefoxitin） or not receiving prophylactic antibiotics were analyzed retrospectively , with curative efficacy compared and pharmacoeconomic evaluation performed by means of cost-effectiveness analysis .RESULTS：Similar curative efficacy was noted for the four regimens;however , the cost-effectiveness ratio in patients treated without antibiotics and in those treated with cefuroxime was lower than in those treated with cefotiam or cefoxitin .CONCLUSIONS： It is preferable to treat patients with chronic cholecystitis single disease undergoing clinical path with cefuroxime or without using prophylactic antibiotics .