3种Ⅰ类切口手术预防性应用抗菌药物个体化量化点评方法的探讨

Approaches of individualized quantification prescription reviews on prophylactic application of antibacterials in three kinds of classⅠincision operations

目的：探讨3种Ⅰ类切口手术预防应用抗菌药物（以下称＂预防用药＂）的个体化量化点评方法。方法：随机选择2014年9-12月和2015年9-12月乳腺疾病手术、甲状腺疾病手术和疝修补术病历资料240份（各120份）,先从用药指征、给药时机、用药持续时间、药物选择、单次用药剂量、联合用药方面进行合理性评价,在此基础上制定量化评价标准,进一步评价其合理性,以χ^2检验对数据进行统计分析。结果：2014年9-12月预防用药百分率为49.17%,2015年9-12月降低为30.00%（P〈0.05）。初次给药时机、品种选择、药品用量、用药持续时间和联合用药的合理用药百分比,2015年组较2014年组相比均有不同程度增加。预防用药的合格率2014年为65.83%,到2015年上升为90.83%（P〈0.05）。根据量化评价标准,2014年和2015年合格率分别为61.67%和80.00%（P〈0.05）。结论：3种Ⅰ类切口手术预防用药的个体化量化医嘱点评可促进其用药的合理性。

Objective： To explore the approaches of individualized quantification prescription review on prophylactic application of antibacterials in three kinds of class I incision operations. Methods： Two hundred and forty case histories of mammary gland operation, thyroid operation and hernia repair, including 120 case histories from Sep 2014 to Dee 2014 and 120 case histories from Sep 2015 to Dec 2015 were chosen randomly for the study. The medication indications, medication time, duration of medication, drug selection, dosage of single medication, and drug combination were used to evaluate the rationality in prophylactic application of antibacterials. Then, quantitative evaluation standards were established and used to reevaluate the rationality of prophylactic application of antibaeterials. Statistical analysis was performed by chi-square test. Results： The percentage of prophylactic application of antibacterials was 49. 17% in Sep 2014 to Dec 2014, however it was reduced to 30.00% in Sep 2015 to Dec 2015 （P〈0.05）. The percentages of rationality of the first medication time, drug selection and dosage of antibacterials, duration of medication, and drug combination in Sep 2015 to Dec 2015 were increased to various extents as compared with those in Sep 2014 to Dec 2014. The total percentage of the rationality was increased from 65.83% in 2014 to 90.83%in 2015 （P〈0.05）. According to the quantitative standards, the total percentage of the rationality in 2014 and in 2015 was 61.67% and 80.00%respectively （P〈0.05）. Conclusion： Individualized quantification prescription review on preoperative prophylactic use of antibaeterials in 3 kinds of class I incision operations could facilitate the rationality of drug use.