高龄女性盆底手术围术期药学路径的建立与成效

发布时间：2018-05-20 08:46

本文选题：高龄女性 + 临床药师　；参考：《中国医院药学杂志》2017年18期

【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(P0.05)。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。
[Abstract]:Objective: to establish perioperative pharmacological pathway of pelvic floor surgery for elderly women and evaluate the effect of intervention by clinical pharmacists on perioperative antimicrobial agents, so as to provide practical basis for rational use of drugs in clinic. Methods: pharmaceutical pathway was established and implemented. The control group (before intervention) was selected from March 2014 to July 2015, and the study group (after intervention) was selected from July 2015 to January 2017. The differences of the rational indexes of antimicrobial agents and adjuvant drugs before and after intervention were compared. Results: after intervention, the rational selection rate of prophylactic antibiotics was increased from 44.8% to 93.1%, the rational rate of combined use of antibiotics was increased from 41.3% to 81.8%, the course of treatment decreased from 4.7 卤0.7 days to 3.3 卤0.5 days, and the per capita cost of antibiotics decreased from 855.9 卤210.3 yuan to 534.5 卤102.4 yuan. The suitable rate of adjuvant drug indication increased from 41.3% to 86.4%, the reasonable rate of course of treatment increased from 55.2% to 90.9, and the per capita cost of auxiliary drug decreased from 318.7 卤85.8 yuan to 202.7 卤79.4 yuan. The difference was statistically significant (P 0.05). Conclusion: it is feasible to implement pharmacological pathway in perioperative period of pelvic floor surgery for elderly women, which can provide effective working model for clinical pharmacists to participate in medical team, and provide practical data for payment of medical insurance single disease.
【作者单位】：南京医科大学附属无锡妇幼保健院;
【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)
【分类号】：R95

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