外科围术期预防性应用抗菌药物调查及药物经济学研究

目的：了解外科围术期抗菌药物预防性使用情况，促进临床合理用药，降低医疗费用。方法：采用回顾性调查方法，对456例外科围术期患者应用抗菌药物的情况进行回顾性分析，采用成本-效果分析方法进行评价。结果：456例患者中，Ⅰ类切口手术208例，Ⅱ类切口手术242例，Ⅲ类切口手术6例；切口愈合率分别为甲级98．68％、乙级1．1％、丙级0．22％；抗菌药物总使用率为97．81％（446例），人均抗菌药物费用为948．5元，由于不合理使用抗菌药物而多支出药品费用达到人均334．76元。结论：外科围术期在抗菌药物种类选择、用药时机和持续用药时间等方面仍存在不合理现象，从而导致医疗费用的增加。

Perioperative Utilization of Prophylactic Antibacterials and Pharmacoeconomic Study

OBJECTIVE： To investigate the perioperative application of prophylactic antibacterials in surgical department to promote clinical rational drug use and lower medical cost. METHODS： The perioperative utilization of prophylactic antibacterials in a total of 456 surgical patients was investigated retrospectively and evaluated by using cost-effectiveness analysis. RESULTS ： Of the total 456 cases, the patients with type I, II and III incisions were 208, 242 and 6 cases, respectively. The wound healing rates of grade A, C and C were 98.68% , 1.1% and 0.22% , respectively. 446 cases （97.81% ） received antibacterials, and the average cost of antibacterials per capita was 948.5 Yuan, with unnecessary cost of 334.76 Yuan per capita caused by irrational use of antihacterials. CONCLUSION ： The perioperaitve utilization of prophylactic antibacterials is somewhat irrational in the choice of variety, medication occasion and medication duration etc, which leads to increased medical cost.