临床药师干预对剖宫产围手术期抗菌药物使用的影响

目的：评价临床药师干预对剖宫产围手术期预防性使用抗菌药物的影响。方法选择2012年7月~9月在陕西省妇幼保健院行剖宫产手术未接受临床药师围手术期抗菌药物使用干预患者纳入未干预组（n=136）,而对2013年7月~9月在同一家医院进行剖宫产手术后接受临床药师围手术期抗菌药物使用干预的患者纳入干预组（n=145）。对其采用回顾性分析方法,对围手术期预防性使用抗菌药物的合理性及住院情况进行比较（本研究遵循的程序符合陕西省妇幼保健院人体试验委员会制定的伦理学标准,得到该委员会批准,分组征得受试对象知情同意,并与之签署临床研究知情同意书）。两组患者平均年龄、手术时间及出血量比较,差异均无统计学意义（P＞0.05）。结果经临床药师干预后,干预后组患者预防性使用抗菌药物在药物选择合理率及术后使用时间合理率方面较未干预前组有显著改善,且差异有统计学意义（χ2=6.30,221.38；P=0.01,0.00）；两组用药时机合理率及平均住院时间比较,差异无统计学意义（χ2/t=1.36,1.60；P=0.24,0.11）；两组人均抗菌药物费用、人均药品总费用及人均住院总费用比较,差异均有统计学意义（t=28.99,5.10,4.23；P=0.00,0.00,0.00）。结论经临床药师干预后,剖宫产手术围手术期对患者预防性使用抗菌药物的合理性有显著提高,减少了患者住院费用。临床药师对围手术期剖宫产患者进行抗菌药物使用干预的方法可行、有效。

Effects of Clinical Pharmacist Intervention on the Use of Antibacterials During Perioperative Period of Cesarean Section

Objective To evaluate the effects of clinical pharmacist intervention on the use of antibacterials during perioperative period of cesarean section.Methods The patients with cesarean section who were not receive clinical pharmacist intervention on the use of antibacterials during perioperative period from July to September 2012 in Shaanxi Martenal and Child Hospital were chosen into non-intervention group（n=136）.The patients with cesarean section who received clinical pharmacist intervention on the use of antibacterials during perioperative period from July to September 2013 in the same hospital were chosen into intervention group（n=145）.The rationality of prophylactic use of antibacterials during perioperative period and effects of hospitalization were compared,retrospectively.The study protocol was approved by the Ethical Review Board of Investigation in Human Beings of Shaanxi Marternal and Child Hospital. Informed consent was obtained from each participating patient.The average age,operation duration and the amount of bleeding had no significant differences between two groups （P〉0.05 ）.Results After the intervention of clinical pharmacist,the rationality of choice of medicine and medication time of the preventive application of antibacterials during perioperative period were statistically improved compared with those of non-intervention（χ2 = 6.30,221.38;P=0.01,0.00 ）.While the time points of prophylaxis use of antibacterials and mean hospital days had no significant differences between two groups（χ2/t=1.36,1.60;P=0.24,0.11）.The per capita antibacterial expense,per capita total medicine expense and per capita total hospitalization expense were statistically lower after intervention（t=28.99,5.10,4.23;P=0.00,0.00, 0.00）.Conclusions The rationality of use of antibacterials during perioperative period of cesarean section were significantly improved after clinical pharmacist intervention,which could reduce hospitalization expense.The clinical pharmacist intervention on the preventative ap