基于AHP-TOPSIS法评价妇科腹腔镜手术预防性应用抗菌药物合理性

Evaluation of rationality of prophylactic use of antibiotics in gynecological laparoscopic surgery based on AHP-TOPSIS method

目的 建立妇科腹腔镜手术预防使用抗菌药物的量化评价体系,以期为妇科腹腔镜手术合理预防使用抗菌药物提供参考。方法 利用医院HIS系统,抽取广州医科大学附属第三医院行妇科腹腔镜手术患者467例,以《抗菌药物临床应用指导原则》《妇科手术感染预防指南》及《中国手术部位感染预防指南》等为依据,由处方点评专家组制定评价标准,采用层次分析法(AHP)联合加权的逼近理想解排序法(TOPSIS)对抽取的病历围术期抗菌药物预防使用进行合理性评价。结果 467例妇科腹腔镜手术病例中,围术期预防性应用抗菌药物合理病例400例(86.02%)、基本合理病例63例(13.55%)、不合理病例2例(0.43%)。结论 该院妇科手术围术期抗菌药物预防使用较合理。AHP-TOPSIS方法简单易行,评价结果客观、全面,且可量化,可用于妇科手术围术期预防用药的合理性评价。

Objective To establish the quantitative evaluation system for prophylactic use of antibiotics in gynecological laparoscopic surgery,in order to provide a reference for clinical rational drug use.Methods Totally 467 patients in the Third Affiliated Hospital of Guangzhou Medical University undergoing gynecological laparoscopic surgery were selected by HIS.Based on the guiding principles of clinical application of antibiotics,the guidelines for the prevention of infection in gynecological surgery and the China guidelines for the prevention of infection in surgical sites,the evaluation criteria were established by expert group,and the rationality of the preventive use of antibiotics in the perioperative period of gynecological laparoscopic surgery was evaluated by using analytic hierarchy process(AHP)combined with the technique for order preference by similarity to ideal solution(TOPSIS).Results Among the 467 cases of gynecological laparoscopic surgery,400 cases(86.02%)were reasonable,63 cases(13.55%)were basically reasonable and 2 cases(0.43%)were unreasonable.Conclusion AHP-TOPSIS method is simple and feasible,and the evaluation results are objective,comprehensive and quantifiable.It can be used to evaluate the rationality of perioperative preventive drugs in gynecological surgery.