摘要
目的:分析医嘱点评干预对医院Ⅰ类切口手术患者围术期抗菌药物使用的影响,为临床Ⅰ类切口手术患者围术期抗菌药物的合理使用提供参考.方法:选取 2020 年 1 月—2021 年 6 月(点评干预前,164 例)和 2021 年7 月—2022 年 12 月(点评干预后,164 例)抚州市东乡区人民医院收治的 328 例Ⅰ类切口手术患者作为研究对象,比较和分析点评干预前后不同手术患者抗菌药物的预防使用率和不合理用药类型.结果:医嘱点评干预后Ⅰ类切口手术患者抗菌药物的预防使用率明显低于医嘱点评干预前(28.66%vs 79.27%,P＜0.05),并且在腹股沟疝手术、乳腺手术、骨科手术、白内障手术、甲状腺疾病手术等术式上的抗菌药物预防使用率均低于医嘱点评干预前(P＜0.05);而医嘱点评结果显示,医嘱点评干预后患者围术期抗菌药物在给药时机、药品选用、用药疗程、用法用量、联合用药等方面的不合理率均明显低于医嘱点评干预前(P＜0.05).结论:医嘱点评干预确实可以有效改善医院Ⅰ类切口手术患者围术期抗菌药物的不合理使用情况,从而提升临床的合理用药水平,进而保障患者的用药安全.
Abstract
Objective:To analyze the effect of medical order comment intervention on perioperative use of antibacterial drugs in patients with Class Ⅰ incision surgery in the hospital,and provide a reference for the clinically rational use of antibacterial drugs in such patients.Methods:A total of 328 patients with Class Ⅰ incision surgery admitted to Dongxiang District People's Hospital of Fuzhou from January 2020 to June 2021(164 patients,before medical order comment intervention)and from July 2021 to December 2022(164 patients,after medical order comment intervention)were selected as the research objects.The preventive use rates and irrational use types of antibacterial drugs in patients with different surgeries before and after the medical order comment interventions were compared and analyzed.Results:After the medical order comment interventions,the preventive use rates of antibacterial drugs in patients with Class Ⅰ incision surgery were significantly lower than those before the medical order comment interventions(28.66％vs 79.27％,P<0.05),and the preventive use rates of antibacterial drugs in the surgical procedures such as inguinal hernia surgery,breast surgery,orthopedic surgery,cataract surgery,and thyroid disease surgery were lower than those before the medical order comment interventions(P<0.05).In addition,the results of medical order comments showed that the irrational rates of perioperative antibacterial drugs in patients after medical order comment interventions were significantly lower than those before medical order comment interventions in terms of timing of administration,drug selection,course of medication,usage and dosage,and combined medication,etc.(P<0.05).Conclusion:The medical order comment interventions can effectively improve the irrational use of perioperative antibacterial drugs in patients with Class Ⅰ incision surgery in the hospital,thereby improving the clinical level of rational drug use and guaranteeing the safe medication of patients.
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