剖宫产术围手术期抗菌药物合理应用干预对照研究

摘要

Objective:To evaluate the rationality of prophylactic use of antibacterial agents during perioperative period in caesarean section with the application of monitoring-training-planning (MTP) mode for intervention control study. Methods:The cases of caesarean section in obstetrics department in our hospital from April to September in 2011 as non-intervention group and those from April to September in 2012 as intervention group were collected. The intervention group was interfered with the MTP mode. The rationalities of perioperative prophylactic application of antibacterial agents were compared between two groups in terms of medicine selection, administration time, hospitalization cost and the average cost of antibacterial agents, etc. Results:With the intervention of MTP mode, the top three antibacterial agents in terms of frequency of usage changed from ceftriaxone, ceftezole, azithromycin to ceftezole, azithromycin, ceftriaxone. The average hospitalization days decreased from 8.6 days to 7.5 days. The average cost decreased from 1 604.58 yuan to 1 077.45 yuan. The average cost of antibacterial agents decreased from 762.48 yuan to 322.16 yuan. Conclusion:Application of MTP intervention mode could improve the rationality of use of antibacterial agents during perioperative period in caesarean section and reduce drug cost, which was effective for improving rational use of antibacterial agents.%　　目的：应用监测-培训-计划（MTP）合理用药干预模式进行干预对照研究，以探讨剖宫产手术围手术期预防用抗菌药物的合理性。方法：分别选取我院产科2011年4–9月接受剖宫产手术病例作为非干预组和2012年4–9月接受剖宫产手术病例作为干预组。干预组采用MTP模式实施干预，非干预组未采用MTP模式进行干预，对两组患者围手术期预防性应用抗菌药物的选择、给药时机、住院药费、平均抗菌药物费用等的合理性进行比较分析。结果：采用MTP模式实施干预后，我院剖宫产手术围手术期预防用抗菌药物的使用频次居前3位者由头孢曲松、头孢替唑、阿奇霉素调整为头孢替唑、阿奇霉素、头孢曲松；平均住院天数由8.6 d下降到7.5 d；平均药费由1604.58元下降到1077.45元；平均抗菌药物费用由762.48元下降到322.16元。结论：采用MTP模式的干预方法能显著提高剖宫产围手术期预防用抗菌药物的合理应用率，降低药物费用，对促进临床合理应用抗菌药物具有良好效果。