临床药师干预腹股沟疝修补术围手术期抗菌药物应用效果与切口感染率对比分析

目的 评价临床药师干预腹股沟疝修补术患者围手术期抗菌药物合理性的效果.方法 分别抽取医院2009年8月-2010年3月(干预前)和2010年8月-2011年3月(干预后)的腹股沟疝修补术出院患者病历各60份,对围手术期预防性应用抗菌药物的合理性进行比较.结果 经临床药师干预,腹股沟疝修补术患者围手术期预防应用抗菌药物,在药物选择、用法用量、联合用药、用药时机与疗程、通用名书写、病历中抗菌药物用药分析等方面较干预前均有明显改善,抗菌药物应用时间由2.35 d下降至0.96d,干预前后使用头孢一、二代的比例分别为5.00课和76.67％,抗菌药物预防应用时间和疗程合理率由25.00％升至90.00％,干预前后切口感染率分别为1.60％和0,差异均有统计学意义(P＜0.05),手术前后体温变化及外周血白细胞计数差异无统计学意义.结论 临床药师对腹股沟疝修补术围手术期预防应用抗菌药物的干预是可行并且有效,可以对Ⅰ类切口围手术期预防用药的安全、有效、合理、经济起到积极的作用.

Contrastive analysis of clinical pharmacist intervening to use of antibiotics and postoperative infection rate during perioperative period of inguinal herniorrhaphy

OBJECTIVE To estimate the effect of clinical pharmacist intervening to the use of antibiotics during perioperative period of inguinal herniorrhaphy.METHODS The clinical data was collected from 60 inpatients from Aug 2009 and Mar 2010(before intervention) and 60 cases between Aug 2010 and Mar 2011(after intervention).The index of evaluation was studied before and after the intervention.RESULTS After intervention of clinical pharmacists,the perioperative prophylactic application of antibiotics of inguinal herniorrhaphy was improved significantly in respect of antibacterial selection,dosage and usage,drug combination,administration time and course,handwriting of generic drugs,using analyses of antibiotics in case history.Total hospitalization day of antibiotic use decreased from 2.35d to 0.96d.Before and after intervention,the percentage of using I and II generation cephalosporins was 5.00% and 76.67%,respectively(P < 0.05).The pass rate of course and time of antimicrobial prophylaxis rose from 25.00% to 90.00%(P < 0.05).The incision infection rates before and after interventions were 1.60% and 0(P < 0.05);the differences in the body temperature and peripheral blood leucocyte counts before and after the operation were not statistically significant.CONCLUSION It is effective and practicable that the clinical pharmacists intervene to the use of antibiotics during perioperative period of inguinal herniorrhaphy.The clinical pharmacist’ s interventions will contribute to the safe,effective,reasonable and economical use of antibiotics.