基于熵权TOPSIS法评价临床药师干预前后剖宫产围手术期预防应用抗菌药物合理性

Evaluation of the rationality of prophylactic antibiotics in perioperative period for cesarean section before and after clinical pharmacists intervention based on entropy weight TOPSIS method

目的采用熵权优劣解距离法(technique for order preference by similarity to ideal solution,TOPSIS)评估临床药师干预前后剖宫产围手术期预防应用抗菌药物的合理性。方法依据《抗菌药物临床应用指导原则》(2015年版),参照药物说明书及相关指南,建立基于熵权TOPSIS的剖宫产围手术期预防性应用抗菌药物评价细则,对新乡医学院第三附属医院2021年第一季度和2022年第一季度出院的剖宫产手术病例进行用药合理性评价。结果与最优方案接近程度(Ci)不小于0.6的病例数由干预前的4例(3.48%)上升至38例(38%),差异有统计学意义(P<0.05)。干预前后十个评价指标中熵权值最大的均为给药时机,权重分别为0.6843和0.7517。结论基于熵权TOPSIS法对剖宫产围手术期预防应用抗菌药物合理性可以综合多个指标进行量化评估,也可对临床药师干预效果进行评价,可为合理用药提供指导。

Objective By using entropy weight TOPSIS method,to evaluate the rationality of prophylactic antibiotics used in perioperative period of cesarean section before and after the intervention of clinical pharmacists.Methods Based on Guiding Principles for Clinical Application of Antibiotics(2015 edition),drug instructions,and related guidelines,rules for evaluation of prophylactic application of antibiotics in perioperative period of cesarean section were established based on entropy weight TOPSIS.Furthermore,the rationality of cesarean section cases in The Third Affiliated Hospital of Xinxiang Medical University in the first quarter of 2021 and the first quarter of 2022 were evaluated.Results The proximity degree(Ci)between the evaluated cases and the optimal plan was not less than 0.6 increased from 4 cases(3.48%)to 38 cases(38%),with a statistically significant difference(P<0.05).Before and after the intervention of clinical pharmacists,the maximum entropy weight of the ten evaluation indexes was drug administration time,with the weights of 0.6843 and 0.7517.Conclusions Based on TOPSIS method of entropy weight,the rationality of the prophylactics antibiotics use in perioperative period of cesarean section can be quantitatively evaluated by synthesizing multiple indicators,and the effect of clinical pharmacists'intervention can also be evaluated in a practical way.