CAJ | 학술논문

目的分析干预前后Ⅰ类切口围术期抗菌药物使用情况,为基层医院抗菌药物的合理使用和规范管理提供依据.方法 2013年1月至12月建立由市卫生局相关人员和医院临床药师组成的专业团队,以南充市10家基层医疗机构578例4种Ⅰ类切口手术(甲状腺手术、乳腺手术、疝修补术、闭合性骨折手术)抗菌药物临床应用情况为研究对象,采取培训、督导及行政干预相结合的方法,对抗菌药物应用及管理进行持续性干预,分析评价干预前后抗菌药物使用情况.结果 Ⅰ类切口手术抗菌药物预防性应用的比例显著降低,使用率从干预前的54. 67%降至干预后的39. 79%,抗菌药物在适应证、药品选择、用法用量、分级使用、溶剂选择、给药途径、用药疗程及给药时机等方面较干预前有较明显的改善.结论实施行政干预和技术指导相结合的措施行之有效,对基层医院Ⅰ类切口围术期抗菌药物的合理应用与管理起到了积极的推动作用,初步建立起一套长效的管理机制.
목적 분석간예전후Ⅰ류절구위술기항균약물사용정황,위기층의원항균약물적합리사용화규범관리제공의거.방법 2013년1월지12월건립유시위생국상관인원화의원림상약사조성적전업단대,이남충시10가기층의료궤구578례4충Ⅰ류절구수술(갑상선수술、유선수술、산수보술、폐합성골절수술)항균약물림상응용정황위연구대상,채취배훈、독도급행정간예상결합적방법,대항균약물응용급관리진행지속성간예,분석평개간예전후항균약물사용정황.결과 Ⅰ류절구수술항균약물예방성응용적비례현저강저,사용솔종간예전적54. 67%강지간예후적39. 79%,항균약물재괄응증、약품선택、용법용량、분급사용、용제선택、급약도경、용약료정급급약시궤등방면교간예전유교명현적개선.결론 실시행정간예화기술지도상결합적조시행지유효,대기층의원Ⅰ류절구위술기항균약물적합리응용여관리기도료적겁적추동작용,초보건립기일투장효적관리궤제.
Objective To analyze the prophylactic use of antibacterial agents from before and after intervention with typeⅠincision oper-ations and to provide a reference for clinical rational drug use of primary hospitals. Methods Through the establishment of a profes-sional team composed of the municipal health bureau and hospital clinical pharmacists;to study 578 medical records of four kinds of type Ⅰincision operations ( thyroid surgery, breast surgery, hernia repair, closed fracture surgery ) were selected from 10 primary hospitals in Nanchong City from Jan to Dec. of 2013 of the clinical application of antibacterial drugs, and take the training, supervision and the method of combining administrative intervention, and persistent intervention of antibacterial drug application and management, for analysis and evaluation of the rationality of the utilization of the prophylactic antibiotics from before and after intervention. Results The appli-cation rate of antibacterial agents for prophylactic purpose in typeⅠincision operations was significantly lower, the utilization rate de-creased from 54. 67% before the intervention to 39. 79% after the intervention, there are more obvious improvement the intervention in the aspects of the indication, election of antibacterial, medication duration, election of solvent, usage and dosage, and combination medica-tion. Conclusion The method of combining administrative intervention with technical guidance was efficacious, further promoted the rea-sonable antimicrobial application in clinic of typeⅠincision operations in primary hospitals, and initially established a long-term man-agement mechanism.