围手术期预防用抗菌药物合理性评价指标体系研究

摘要

目的：建立围手术期预防用抗菌药物合理性评价指标体系，促进围手术期预防用抗菌药物使用的合理性。方法：于本院病历检索系统中随机抽取250例围手术期预防用抗菌药物病例，设计围手术期预防用抗菌药物调查表。搜集有关围手术期预防用抗菌药物合理性评价体系研究的相关资料，以国家颁布的有关抗菌药物合理性评价的指南和规定为指导，采用Delphi Method法建立围手术期预防用抗菌药物合理性评价指标体系。并运用该评价指标体系对本组患者用药的合理性进行综合评价。结果：本研究建立了一个由3个一级指标和13个二级指标组成的评价体系。该指标体系对本组患者围术期预防用药的评价结果为：有用药指征患者共202例（80.8%），无用药指征患者共48例（19.2%）；用药方案不合理患者占总体患者的比率依次为：药物选择12.8%、给药途径4.8%、溶媒选择5.2%、溶媒用量10%、用药频次20.8%、用药剂量22%。同时，本组患者围术期使用预防用抗菌药物后，仅2例患者出现轻微手术部位感染，比率为0.8%。结论：Delphi Method法下建立的由3个一级指标和13个二级指标组成的评价体系能系统性的对围手术期预防用抗菌药物使用的合理性进行评价，较客观标准。%Objective:To establish rational evaluation index system and to improve the rationality of prophylactic use the antibiotics during perioperation period.Method:250 cases were randomly collected and analyzed by the relevant medical records of antibacterials during perioperation period,then questionnaire about prophylactic used of antibiotics during perioperation period was designed. After that,the relevant data of prophylactic used of antibiotics during perioperation period was collected and the perioperation period of prophylactic antimicrobial evaluation index system of drugs with Delphi Method method was used to analyze and evaluate the rationality of prophylactic use of antibiotics. Result:The result used a evaluation index system consist of three first class indexes and thirteen second class indexes were that there were 202 cases(80.8%)with drug indications in patients while 48 cases(19.2%)without drug indications. Unreasonable medication proportions of total patients as follows:drug selection was 12.8%,administration route was 4.8%,irrational solvent choice was 5.2%,the solvent amount was 10%,the total application frequency of administration was 20.8%,the dose of drug was 22%.At the same time,only two patients had mild operation site infection in this group of patients after using prophylactic antibiotics,of which the utilization ratio was 0.8%. Conclusion:The evaluation index system of prophylactic use of antibiotics during perioperation period,which consists of three first class indexes and thirteen second class indexes using the established Delphi Method method is feasible and rational.