摘要
目的:通过建立高龄女性盆底手术围术期药学路径,评价临床药师干预围术期抗菌药物、辅助用药的成效,为临床合理用药提供实践依据。方法:制定药学路径并实施,对照组(干预前)为2014年3月-2015年7月出院的入选病例;研究组(干预后)为2015年7月-2017年1月出院的入选病例。比较干预前后抗菌药物、辅助用药合理性各项指标的差异。结果:经干预后,高龄女性盆底手术围术期预防用抗菌药物选择合理率由44.8%增至93.1%,联合用药合理率由41.3%增至81.8%,疗程由(4.7±0.7)d降至(3.3±0.5)d,抗菌药物人均费用由(855.9±210.3)元降至(534.5±102.4)元;辅助用药适应证适宜率由41.3%增至86.4%,疗程合理率由55.2%增至90.9%,辅助用药人均费用由(318.7±85.8)元降至(202.7±79.4)元,差异均具有统计学意见(P<0.05)。结论:高龄女性盆底手术围术期实施药学路径可行,可为临床药师参与医疗团队提供有效的工作模式,也能为医保单病种付费提供实践数据。
OBJECTIVE To evaluate the effect of perioperative application of antimicrobial and adjuvant drugs by clinical pharmacist interventions,and provide a practical basis for rational drug use through establishing the perioperative pharmaceutical path for the elderly female patients undergoing gynecological pelvic floor surgery.METHODS The pharmaceutical path was established and performed.Patients discharged from March2014 to July2015 were assigned in control group（before intervention）,and patients discharged from July 2015 to January 2017 were included in research group（after intervention）.The rationality differences of the antimicrobial and adjuvant drugs were compared before and after the intervention.RESULTS Rational use rate of antimicrobial drugs increased from44.8%to 93.1%after intervention,the rationality of combined medication increased from41.3%to 81.8%,the duration reduced from（4.7±0.7）d to（3.3±0.5）d,and the drug cost per patient decreased from（855.9±210.3）Yuan to（534.5±102.4）Yuan（all P〈0.05）.Rational use rate of adjuvant drugs increased from41.3%to 86.4% after intervention,the rationality of duration increased from55.2% to 90.9%,and the drug cost per patient decreased from（318.7±85.8）Yuan to（202.7±79.4）Yuan（all P〈0.05）.CONCLUSION It is feasible to adopt perioperative pharmaceutical path during gynecological pelvic floor surgery in elderly females,which can provide an effective working mode for the clinical pharmacists to participate in the medical teams,and also provide practical data for the single disease payment.
出处
《中国医院药学杂志》
CAS
北大核心
2017年第18期1842-1846,共5页
Chinese Journal of Hospital Pharmacy
基金
高龄妇女妇科手术围术期药学监护的研究无锡市医管中心科研面上项目(编号:YGZXM14019)
关键词
高龄女性
临床药师
药学路径
盆底手术
围手术期
elderly female
clinical pharmacists
pharmaceutical path
pelvic floor surgery
perioperative period
