中国现代药物应用2019年10月第13卷第20期 Chin J Mod Drug Appl, Oct 2019, Vol. 13, No. 20
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临床药师干预对外科围术期预防性应用抗菌药物的 影响分析
谢家隆
【摘要】 目的 探讨临床药师干预对外科围术期预防性应用抗菌药物的影响。方法 200例外科围术期预防性应用抗菌药物患者, 按照随机数字表法分为研究组和对照组, 每组100例。研究组采用临床药师干预, 对照组采用药物治疗委员会制定的临床预防性抗菌药物使用规范进行临床指导。对比两组患者抗菌药物使用情况, 观察两组患者抗菌药物使用频次前五位的药品。结果 研究组患者术前合理用药率95.0%、单种用药率92.0%均高于对照组的83.0%、76.0%, 差异具有统计学意义(P<0.05)；研究组患者术后用药时间(20.15±4.15)h、围术期用药时间(4.26±1.25)d及住院时间(5.92±2.15)d均短于对照组的(25.26±4.62)h、(7.23±1.36)d、(9.81±3.26)d, 差异具有统计学意义(P<0.05)。与对照组对比, 研究组患者含酶类及第三代头孢菌素类抗菌药物使用率降低, 第二代头孢菌素类药物使用率上升。结论 临床药师干预在外科围术期预防性应用抗菌药物中具有良好导向作用, 能够有效规范抗菌药物合理使用, 减少抗菌药物使用频次, 缩短治疗周期, 适用于临床推广。
【关键词】 临床药师干预；外科手术；围术期；预防性应用；抗菌药物DOI：10.14164/j.cnki.cn11-5581/r.2019.20.064Effect of clinical pharmacist intervention on prophylactic use of antibiotics during perioperative period XIE Jia-long. Dongguan People’s Hospital, Dongguan 523000, China
【Abstract】 Objective To discuss the effect of clinical pharmacist intervention on prophylactic use of antibiotics during perioperative period. Methods A total of 200 cases of perioperative prophylactic use of antibiotics were divided into research group and control group according to random number table method, with 100 cases in each group. The research group received clinical pharmacist intervention, and the control group was guided by the clinical prophylactic antibiotics usage criteria formulated by the Drug Treatment Committee. The use of antibiotics in the two groups was compared, and the top five antibiotics in the two groups were observed. Results The rational drug use rate before operation 95.0% and single drug use rate 92.0% in the research group was higher than 83.0% and 76.0% in the control group, and their difference was statistically significant (P<0.05). The medication time after operation (20.15±4.15) h, medication time during perioperative period (4.26±1.25) d and hospitalization time (5.92±2.15) d in the research group was shorter than (25.26±4.62) h, (7.23±1.36) d and (9.81±3.26) d in the control group, and their difference was statistically significant (P<0.05). Compared with the control group, the use of enzymes and third-generation cephalosporins in the research group decreased, while the use of second-generation cephalosporins increased. Conclusion Clinical pharmacist intervention has a good guiding role in the prophylactic use of antibiotics in perioperative period. It can effectively standardize the rational use of antibiotics, reduce the frequency of antibiotics use, shorten the treatment cycle, and is suitable for clinical promotion.
【Key words】 Clinical pharmacist intervention; Surgical operation; Perioperative period; Prophylactic use; Antibiotics
随着临床药学不断发展, 临床可供选择的抗菌药物不断增加, 如何选择安全、高效的抗菌药物具有重要临床意义。抗菌药物临床应用可有效避免外界病原体的感染及侵袭, 对患者起保护作用, 于围术期应用效果显著, 针对手术患者, 在机体免疫功能低下的情况, 可有效减少细菌对机体的侵害, 减少术后并发症发生情况［1］。为此, 本研究特选取200例外科围术期患者作为研究对象, 旨在分析临床药师干预对外科围术期预防性应用抗菌药物的影响, 现报告如下。1 资料与方法
1. 1 一般资料 选取2018年1~12月本院收治的200例外
科围术期预防性应用抗菌药物患者作为研究对象, 按照随机数字表法分为研究组和对照组, 每组100例。对照组患者中男52例, 女48例；年龄22~62岁, 平均年龄(39.52± 8.42)岁；甲状腺手术20例, 肝胆手术27例, 下肢静脉结扎手术8例, 腹股沟疝手术15例, 乳腺手术19例, 胃肠道手术11例。研究组患者中男53例, 女47例；年龄21~68岁, 平均年龄(40.52±9.98)岁；甲状腺手术22例, 肝胆手术26例, 下肢静脉结扎手术10例, 腹股沟疝手术18例, 乳腺手术16例, 胃肠道手术8例。两组患者性别、年龄、手术类型等一般资料比较差异无统计学意义(P>0.05), 具有可比性。纳入标准：①患者均符合外科手术要求；②患者及家属对本项研究知情且签署书面知情同意书；③患者年龄21~68岁, 具有良好的认知功能；④治疗依从性较好。排除标准：①手术禁忌证患
作者单位：523000 东莞市人民医院
临床药师干预对外科围术期预防性应用抗菌药物的影响分析 - 论文
