药学干预对妇科清洁手术围术期预防应用抗菌药物的影响及价值

Effect and value of pharmaceutical intervention on the prevention and application of antibiotics in the perioperative gynecological aseptic operation

目的:通过分析临床药学干预措施对妇科清洁手术围术期预防应用抗菌药物的影响,为临床药学工作的开展提供参考依据。方法:选取2013年3月至2014年2月、2014年3月至2015年2月、2015年3月至2017年2月于郑州市妇幼保健院妇科实施清洁手术的全部出院患者551例、506例和739例分别作为干预前、干预中和干预后组;采用药学干预措施后,对比分析干预前、中、后组抗菌药物应用方面的指标变化、手术部位感染率及不良反应发生率等。结果:干预中、干预后组围术期预防应用抗菌药物使用率、使用强度及抗菌药物费用显著下降,用药指征和术后用药维持时间合理率提升;干预前、中、后3组患者手术部位感染率、住院时间比较差异无统计学意义(P>0.05);3组均无药物不良反应发生。结论:药学干预使抗菌药物在妇科清洁手术围术期的预防应用更加合理规范,是安全可行的,而且对减少抗菌药物不规范暴露,遏制细菌耐药,降低医疗费用,节约卫生资源具有深远的社会意义。

Objective To analyze the effect of clinical pharmacy intervention on the prevention and application of antibiotics in the perioperative period of gynecologic cleaning operation,and provide a reference for the development of clinical pharmacy.Methods From March 2013 to February 2014,March 2014 to February 2015,March 2015 to February 2017,551,506,and 739 cases of clean operation in Women ＆ Infants Hospital of Zhengzhou were selected as before intervention group,intervention group,and after intervention group,respectively.After the pharmaceutical intervention,the changes in the application index of antibiotics,the rate of surgical site infection,and the incidence of adverse reactions were compared and analyzed among the 3 groups.Results The use rate,intensity,and cost of antibiotics in the intervention group and after intervention group was decreased significantly,while the reasonable rate of drug indications and postoperative medication indication was improved.There was no statistically significant difference in surgical site infection rate and length of stay among the 3 groups（ P〉0.05）,and no adverse reactions occurred in the 3 groups.Conclusion The pharmaceutical intervention of antibacterial drugs in prevention of clean surgery in gynecology perioperative period is more reasonable,safe,and feasible,and it has far-reaching social significance for reducing antibiotics,drug resistance,medical costs,and health resources.