骨科Ⅰ类切口围术期抗菌药物应用调查及药物经济学评价

目的:了解我院骨科Ⅰ类切口手术围术期抗菌药物的应用情况。方法:随机抽取我院骨科2010年9月-2011年2月出院的Ⅰ类切口手术患者病历,对抗菌药物的应用情况进行分析,并采用药物成本-效果分析方法进行评价。结果:在329例骨科Ⅰ类切口手术患者中,围术期均应用了抗菌药物,术前0.5～2h给药者有298例(90.58%),平均用药时间为(4.21±2.5)d,使用频次最高的是头孢孟多(23.94%)。其中,术前用药时机不合理者有31例(9.42%),疗程不合理者有285例(86.63%),品种选择不当者有36例(10.94%),给药次数不合理者有9例(2.74%)。由于不合理用药而多支出的费用人均达661.17元。结论:我院骨科Ⅰ类切口手术围术期抗菌药物应用存在术前用药时机选择不当、预防用药时间过长和药物品种选择不当等情况,由此导致医疗费用增加;应继续加强对围术期抗菌药物应用监管,以达到安全、有效、经济用药的目的。

Investigation on the Perioperative Application of Antibacterials in Type ⅠIncision Orthopedic Operation and Pharmacoeconomic Study

OBJECTIVE： To investigate the perioperative application of antibacterials in type Ⅰ incision orthopedic operation in our hospital. METHODS： The medical records of patients undergoing type Ⅰ incision orthopedic operation were randomly sampled from our hospital during Sept. 2010-Feb. 2011. The perioperative application of antibacterials was analyzed and was evaluated by cost-effectiveness analysis. RESULTS： 329 patients undergoing type Ⅰ incision orthopedic operation all received perioperative appli- cation of antibacterials. 298 patients （90.58%） received antibacterials during 0.5-2 h before the operation. The mean duration for patients receiving antibacterials was （4.21± 2.5） d. Cefamandole was the most frequently administered preoperatively （23.94%）. The medication timing before operation was not correct in 31 cases （9.42%）. Treatment course was irrational in 285 cases （86.63%）. The choice of antibacterials was not suitable in 36 patients（10.94% ）. The medication time was irrational in 9 cases （2.74%）. The unnecessary cost was 661.17 yuan per capita for irrational drug use. CONCLUSION： Irrational use of perioperative antibacterials, such as unsuitable medication timing, prolonged duration of administration, unsuitable choice of antibacterials, lead to increased medical cost. The perioperative application of antibacterials should be standardized for a safe, effective and economical goal in our work.