子宫肌瘤切除围手术期预防应用抗菌药物干预的分析

Comparative analysis of intervention effects on the prophylactic use of antibiotics during perioperative period of myomectomy

目的评价临床药师干预子宫肌瘤切除术患者围手术期抗菌药物应用的效果。方法分别抽取医院2013年7~12月（干预前）和2014年1~6月（干预后）的子宫肌瘤切除术病历各50份,对抗菌药物在围手术期预防性应用的合理性进行比较。结果干预前、后抗菌药物使用率为100%,联合用药比例由70%降至64%;品种选择合理率由78.0%升至100.0%,抗菌药物疗程合理率由10.0%升至58.0%,差异有统计学意义（P〈0.05）;总药品费用占住院总费用的比例由30.0%降至27.3%,抗菌药物总费用占总药品费用的比例由32.0%降至23.0%;患者人均住院时间减少1.08d。结论临床药师对围术期预防应用抗菌药物进行干预可行且有效,能提高医院抗菌药物的合理使用水平,减少患者的住院时间和住院费用。

Objective To estimate the intervention effects of clinical pharmacists on the use of antibiotics during perioperative period of myomectomy .Methods The clinical data were collected from 50 patients with myomectomy from July to December in 2013 （before intervention） and 50 patients from January to June in 2014（after intervention） .The rationality of antibiotics application was evaluated thereafter .Results The use rate of antibiotics was 100% before and after the intervention .After intervention by clinical pharmacists ,the combined medication rate declined from 70% to 64% ;the rate of rational variety choice increased from 78 .0% to 100 .0% ;the rate of rational course of treatment was improved from 10 .0% to 58 .0% ,with statistical significance（P〈0 .05） .The proportion of the total drug cost accounting for the total cost of hospitalization decreased from 30 .0% to 27 .3% ,and the percentage of total antibiotics expense in the total medicine expense decreased from 32 .0% to 23 .0% .The mean hospitalization stay per patient decreased 1 .08 days .Conclusion The preventive use of antibiotics in sterile surgery during perioperative period by the clinical pharmacists is feasible and effective ,which could improve the level of rational antibiotic use and decrease the hosital stay and expenses .