临床药师干预Ⅰ类切口围术期抗菌药物应用分析

Application of Antimicrobial Agent in Perioperation of Ⅰ Class Incision under Intervention by Clinical Pharmacists

目的探讨临床药师利用循证医学证据干预Ⅰ类切口围术期应用抗菌药物的效果,为提高外科清洁手术使用抗菌药物的临床管理提供更多依据。方法将在2011年1月至12月和2014年1月至12月各抽取的600份行Ⅰ类切口手术患者病历资料设为对照组和观察组。临床药师从2011年1月开始利用循证医学证据干预围术期抗菌药物的应用。结果观察组围手术期的抗菌药物人均用药天数、预防性使用抗菌药物的比例及不合理率均明显少于对照组(P<0.05)。观察组预防性使用抗菌药物符合术前0.5~2.0 h给药的比例和选用非限制使用级的比例均显著高于对照组(P<0.05)。结论临床药师利用循证医学证据对Ⅰ类切口围术期应用抗菌药物实施干预,可明显减少人均用药天数,将抗菌药物比例控制在合理范围内,减少不合理用药的发生,有利于规范临床抗菌药物的应用。

Objective To investigate the application of antimicrobial agent in perioperation of Ⅰ class incision under intervention by clinical pharmacists who uses evidence- based medical testimony,and to provide more basis to raise the clinical management of antimicrobial agents in surgical clean procedure. Methods 600 medical records of patients with type Ⅰ incision operation were respectively extracted from 2011 and 2014 respectively,which were set as control group and observation group according to random number table method. Clinical pharmacists began to use evidence- based medical testimony to interfere the application of antimicrobial agent from January 2011. Results Medication capita number days in perioperation,proportion of antimicrobial agents for Prophylactic use and unreasonable rate of observation group were significantly less than those of control group( P < 0. 05). Prophylactic use of antimicrobial agents in accordance with 0. 5- 2. 0 h dosing proportion and the proportion of choice of non- restriction of observation group were significantly higher than those of control group( P < 0. 05). Conclusion Clinical pharmacists use evidence- based medical testimony to interfere the application of antimicrobial agents in perioperation of Ⅰ class incision,which can significantly reduce the per capita number days,control the proportion of antimicrobial agents in a reasonable scope,and reduce the occurrence of irrational drug use. It is helpful to standardize clinical application of antimicrobial agent.