基于加权TOPSIS法的胆囊切除术预防性应用抗菌药物合理性评价

Rationality Evaluation of Preventive Application of Antibiotics for Cholecystectomy Based on Weighted TOPSIS Method

目的:建立基于加权优劣解距离法(TOPSIS)的胆囊切除术预防性应用抗菌药物评价细则,为临床合理使用抗菌药物提供参考。方法:以《抗菌药物临床应用指导原则(2015年版)》、药品说明书为基础,参照相关指南及文献,制定基于加权TOPSIS法的胆囊切除术预防性应用抗菌药物评价细则,以此为依据,对马鞍山十七冶医院2019年上半年的外科76例腹腔镜胆囊切除术患者归档病历进行评价。结果:评价的76例病历中,与最优方案接近程度大于70%的9例(11.84%),接近程度50%~70%的35例(46.05%),接近程度40%~50%的32例(42.11%)。结论:基于加权TOPSIS法的胆囊切除术预防性应用抗菌药物合理性评价将多个指标结合起来,评价结果更加清晰、扼要、可靠。本院腹腔镜胆囊切除术患者围手术期抗菌药物使用不合理现象较为普遍,医院需加强管理,进一步规范预防性应用抗菌药物的合理使用。

Objective: To establish a method based on the weighted technique for order preference by similarity to ideal solution( TOPSIS) method for evaluating the preventive application of antibiotics for cholecystectomy to provide reference for rational use of antibacterial drugs. Methods: Based on Guiding Principles for Clinical Application of Antimicrobial Drugs( 2015) and drug instructions,the guidelines for the preventive application of antibiotics for cholecystectomy based on the weighted TOPSIS method were formulated with reference to the relevant guidelines and literature. Furthermore,the use of laparoscopic cholecystectomy in 76 inpatients of Ma’anshan Shiqiye Hospital in the first half of 2019 was evaluated. Results: Among the 76 cases,9 ones( 11.84%) were with more than 70%relative proximity to the optimal treatment regimen,35 ones( 46.05%) were with 50%-70% relative proximity,and 32 ones( 42.11%)were with 40%-50% relative proximity. Conclusion: The rationality evaluation of preventive application of antibiotics for cholecystectomy based on the weighted TOPSIS method combines multiple factors affecting the treatment of cholecystectomy. The evaluation is more concise,intuitive and reliable than the traditional single index evaluation. The evaluation results showed that unreasonable use of perioperative antibiotics still existed,and the hospital needs to strengthen the management to further regulate the rational use of antibacterial drugs.