药学干预对老年慢性阻塞性肺疾病急性加重期患者抗菌药物合理使用的影响分析

Analysis of the Influence of Pharmaceutical Intervention on the Rational Use of Antibiotics in Elderly Patients with Chronic Obstructive Pulmonary Disease in Acute Exacerbations

目的探讨药学干预对老年慢性阻塞性肺疾病急性加重期(AECOPD)患者抗菌药物合理使用的影响。方法选取该院2010年2月—2021年4月收治的146例AECOPD患者为研究对象,采用随机数表法均分成两组,各73例。其中对照组患者常规治疗,药学干预不介入;观察组患者常规治疗基础上,药学干预介入。对比两组患者病情控制情况、肺功能变化及抗菌药物合理使用情况。结果观察组患者喘息缓解时间、咳嗽缓解时间、肺部听音改善时间分别为(2.86±0.65)d、(6.10±1.87)d、(6.58±1.82)d,对照组分别为(2.95±0.68)d、(5.95±1.78)d、(6.61±1.78)d,差异无统计学意义(t=0.817、0.496、0.101,P>0.05)。治疗前两组患者肺功能指标FEV1、FVC、FEV1/FVC对比差异无统计学意义(t=0.398、0.192、0.662,P>0.05);治疗后两组患者FEV1、FVC、FEV1/FVC对比差异无统计学意义(t=0.352、0.098、1.773,P>0.05)。观察组剂量不合理、联用药物不合理、药物种类不合理等总发生率为2.74%,对照组总发生率为13.70%,观察组低于对照组,差异有统计学意义(χ^(2)=5.881,P<0.05)。结论在治疗AECOPD患者过程中增加药学干预对治疗疗效无不良影响,但可显著减少用药不合理的发生,保障患者用药安全性。

Objective To investigate the effect of pharmaceutical intervention on the rational use of antibiotics in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 146 AECOPD patients admitted to the hospital from February 2010 to April 2021 were taken as the research objects.They were divided into two groups by random number table method,with 73 cases in each group.Among them,patients in the control group were treated with routine treatment,and pharmaceutical intervention was not involved.On the basis of conventional treatment,patients in the observation group received pharmaceutical intervention.The condition of disease control,changes in lung function and rational use of antibacterial drugs were compared between the two groups.Results The wheezing relief time,cough relief time,and lung hearing improvement time of the observation group were(2.86±0.65)d,(6.10±1.87)d,and(6.58±1.82)d,respectively.The control group was(2.95±0.68)d,(5.95±1.78)d,(6.61±1.78)d,there was no statistically significant difference between the two groups(t=0.817,0.496,0.101,P>0.05).Before treatment,there was no statistically significant difference in pulmonary function indexes FEV1,FVC,FEV1/FVC between the two groups of patients(t=0.398,0.192,0.662,P>0.05).After treatment,there was no statistically significant difference in FEV1,FVC,FEV1/FVC between the two groups of patients(t=0.352,0.098,1.773,P>0.05).The total incidence of unreasonable doses,unreasonable combination drugs,and unreasonable drug types in the observation group was 2.74%,and the total incidence in the control group was 13.70%,which was lower in the observation group than in the control group,the difference was statistically significant(χ^(2)=5.881,P<0.05).Conclusion Adding pharmaceutical intervention during the treatment of patients with AECOPD has no adverse effect on the therapeutic effect,but it can significantly reduce the occurrence of unreasonable medications and ensure the safety of medications for patients.