冠状动脉内支架植入术患者围术期预防用抗菌药物干预前后的对比分析

目的：分析冠状动脉内支架植入术（PICAS）患者围术期预防用抗菌药物干预前后的合理性的效果.方法：选取2012年1-2月间962例PICAS患者作为干预前组和2012年4-5月间946例PICAS患者作为干预后组;对围术期预防用抗菌药物的合理性及术后的感染率进行分析.结果：PICAS患者预防用抗菌药物,经临床药师干预后在药物选择、用法用量、给药时机与疗程、特殊情况记录等方面均较干预前规范,抗菌药物的使用率由100％降至1.37％,抗菌药物使用的合理率由4.78％升至100％,平均使用疗程由2.7 d降至＜1d,干预前后感染率分别为0.10％和0,经统计学分析,其差异均有统计学意义（P＜0.05）.结论：临床药师对PICAS患者围术期抗菌药物的使用干预,加强了抗菌药物的合理使用,其效果显著;对于术前无感染的PICAS患者,一般情况下不需要使用抗菌药物预防术后感染.

Contrast Analysis of Before and After Intervention of Perioperative Preventive Use of Antimicrobials in Patients with PICAS

Objective： To assess the effect of clinical pharmacist＇s intervening in the use of antibiotics during perioperative period of the coronary artery stand interpolation and to investigate the necessity of prophylactic antibiotics use for coronary artery stand interpolation. Methods：962 cases of the coronary artery stand interpolation from Jan 2012 to Feb 2012 were selected to be the intervening anterior group and 946 cases from Apr. 2012 to May 2012 to be the posterior group. The rationality of preventative application for antibiotics and the infection rate were stasticed and analyzed. Results： After the interventions by the clinical pharmacists, the preventative application of antibiotics for coronary artery stand interpolation was more normative than before in aspects of the medicine selection, dosage and usage, administration time and course, special circumstance record and so on. The usage rate of antibiotics decreased from 100% to 1.37%. The rationality of antibiotics use rose from 4.78% to 100%. The mean course of antibiotic use decreased from 2.7 d to 1 d. These differences were statistically significan（tP0.05）.The infection rates before and after interventions were 0.10% and 0% and the differences were not statistically significant（P0.05）. Conclusion： The intervention to the preventative application of antibiotics during perioperative period of coronary artery stand interpolation by clinical pharmacists is effective, which can strengthen the rational use of antibiotics significantly. In general conditions, prophylactic antibiotic is unnecessary for coronary artery stand interpolation patients in the condition without pre-procedure infection.