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1.合肥市第二人民医院/安徽医科大学附属合肥医院药学部,合肥;230011
2.中国科学技术大学附属第一医院(安徽省立医院)健康管理中心,合肥 230001
Published:15 July 2023,
Received:30 December 2022,
Revised:05 May 2023,
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张晶晶,王凤玲,孟祥云等.PDCA循环对腹腔镜下胆囊切除术围手术期预防使用抗菌药物的影响效果分析 Δ[J].中国药房,2023,34(13):1632-1636.
ZHANG Jingjing,WANG Fengling,MENG Xiangyun,et al.Effect analysis of PDCA cycle on prophylactic use of antibiotics in laparoscopic cholecystectomy during perioperative period[J].ZHONGGUO YAOFANG,2023,34(13):1632-1636.
张晶晶,王凤玲,孟祥云等.PDCA循环对腹腔镜下胆囊切除术围手术期预防使用抗菌药物的影响效果分析 Δ[J].中国药房,2023,34(13):1632-1636. DOI: 10.6039/j.issn.1001-0408.2023.13.17.
ZHANG Jingjing,WANG Fengling,MENG Xiangyun,et al.Effect analysis of PDCA cycle on prophylactic use of antibiotics in laparoscopic cholecystectomy during perioperative period[J].ZHONGGUO YAOFANG,2023,34(13):1632-1636. DOI: 10.6039/j.issn.1001-0408.2023.13.17.
目的
2
评价PDCA循环在腹腔镜下胆囊切除术围手术期预防使用抗菌药物发挥的作用并进行药物经济学分析。
方法
2
采用回顾性分析方法,随机抽取合肥市第二人民医院根据发生不合理用药的真正或根本原因采取PDCA循环干预前(2019年5-6月)、第1轮PDCA循环干预后(2020年5-6月)、第2轮PDCA循环干预后(2021年5-6月)进行腹腔镜下胆囊切除术的出院患者各80例,对患者进行预防使用抗菌药物的合理性进行点评。对比干预前及第1、2轮PDCA循环干预后患者的一般情况、抗菌药物使用情况、临床疗效、治疗成本,并采用成本-效果分析法及敏感度分析法评价PDCA循环的药物经济学意义。
结果
2
第2轮PDCA循环干预后,抗菌药物使用不合理率、抗菌药物金额占比、抗菌药物使用天数、用药频度、药物利用指数、人均抗菌药物使用频次、抗菌药物总用量、抗菌药物费用、药品总金额、住院总费用较干预前均显著下降/减少(
P
<0.05)。成本-效果分析结果提示,第2轮PDCA循环干预后的药物经济学效果最佳;敏感度分析结果趋势一致,证实研究结果可靠。
结论
2
PDCA循环促进了腹腔镜下胆囊切除术围手术期预防使用抗菌药物的合理应用,降低了抗菌药物费用,减轻了患者就医的经济负担。
OBJECTIVE
2
To evaluate the effect of PDCA cycle on prophylactic use of antibiotics in laparoscopic cholecystectomy during perioperative period and to conduct pharmacoeconomic analysis.
METHODS
2
Using retrospective analysis method, 80 discharged patients of each group underwent laparoscopic cholecystectomy were randomly selected from Hefei Second People’s Hospital before PDCA cycle (from May to June 2019), after the first round of PDCA cycle (from May to June 2020), after the second round of PDCA cycle (from May to June 2021) according to real or basic reasons for irrational drug use. The rationality of prophylactic use of antibiotics for patients was evaluated. The general situation, antibiotic use, clinical efficacy and treatment cost of patients were compared before cycle and after the first and second rounds of PDCA cycle. Cost-effectiveness analysis method and sensitivity analysis method were adopted to evaluate pharmacoeconomic significance of PDCA cycle.
RESULTS
2
After two rounds of PDCA cycle, the irrational rate of antibiotics, cost ratio of antibiotics, the number of days of antibiotics use, DDDs, drug utilization index, the frequency of antibiotics use per capita, the total amount of antibiotics, the cost of antibiotics, the total amount of drugs, and the total cost of hospitalization all decreased significantly (
P
<0.05). The results of cost-effectiveness analysis indicated that the pharmacoeconomic effect was the best after two rounds of PDCA cycle; the results of sensitivity analysis were consistent with it, which confirmed the reliability of the research results.
CONCLUSIONS
2
PDCA cycle promotes the rational use of antibiotics of laparoscopic cholecystectomy during perioperative period, reduces the cost of antibiotics and relieves the economic burden of patients.
PDCA循环腹腔镜下胆囊切除术围手术期抗菌药物成本-效果分析敏感度分析
laparoscopic cholecystectomyperioperative periodantibioticscost-effectiveness analysissensitivity analysis
国家卫生健康委.国家卫生健康委办公厅关于做好医疗机构合理用药考核工作的通知:国卫办医函〔2019〕903号[EB/OL].(2019-12-20)[2022-04-03]. http://www.nhc.gov.cn/yzygj/s7659/201912/5acbea335f5e458ba65a50c779-aa62e8.shtmlhttp://www.nhc.gov.cn/yzygj/s7659/201912/5acbea335f5e458ba65a50c779-aa62e8.shtml.
朱永红,张延华. PDCA质量控制管理模式对抗菌药物临床应用的效果[J]. 临床合理用药杂志,2022,15(16)1-4,8.
史金平,梁昕,肖汉,等. 临床药师促进某院Ⅰ类切口手术围手术期预防使用抗菌药物科学化管理实践[J]. 中国医药导刊,2022,24(7):719-724.
秦艳娥,钟慧,陈彪,等. PDCA循环管理干预骨科Ⅰ类切口手术围术期抗菌药物预防应用的效果评价[J]. 中国药房,2017,28(5):690-693.
国家卫生和计划生育委员会.2013年全国抗菌药物临床应用专项整治活动方案[EB/OL].(2013-05-06)[2023-05-15]. https://view.officeapps.live.com/op/view.aspx?srchttps://view.officeapps.live.com/op/view.aspx?src=http%3A%2F%2Fwww.nhc.gov.cn%2Fewebeditor%2Fuploadfile%2F2013%2F05%2F20130509133856278.doc& wdOrigin=BROWSELINK.
国家卫生计生委办公厅,国家中医药管理局办公室,解放军总后勤部卫生部药品器材局.抗菌药物临床应用指导原则:2015年版[EB/OL].(2015-08-27)[2023-05-15]. http://www.nhc.gov.cn/ewebeditor/uploadfile/2015/09/20150928170007470http://www.nhc.gov.cn/ewebeditor/uploadfile/2015/09/20150928170007470.
冯钟煦,顾家琪,刘剑,等. 普外科患者术后切口感染病原菌分布情况及影响因素logistic回归分析[J]. 现代生物医学进展,2019,19(23):4553-4557.
张旭平,陈海涛. 药物利用指数的不合理使用分析[J].中国医院药学杂志,2021,41(23):2487-2489.
中华消化杂志编辑委员会,中华医学会消化病学分会肝胆疾病协作组.中国慢性胆囊炎、胆囊结石内科诊疗共识意见:2018年[J].中华消化杂志,2019,39(2):73-79.
宗欣,孙利华. 药物经济学评价方法及其评价标准[J]. 中国药物经济学,2011,6(3):79-85.
安徽省医药品价格和集采中心.关于执行国家组织药品集采中选结果落实网上集采有关事项通知:药采〔2019〕109号[EB/OL].(2019-12-20)[2023-05-15]. http://www.ahyycg.cn/detail/categoryDetail.html?idhttp://www.ahyycg.cn/detail/categoryDetail.html?id=1801.
梁颖娥,钟慧,蓝晓步,等. 基于循证药学及PDCA循环建立的重点监控药品合理使用评价模式的应用价值[J]. 临床合理用药杂志,2021,14(14):1-3,6.
曾文玲,许林凤,刘艳. 个性化防控对降低普外科手术患者医院感染发病率的效果观察[J]. 中国当代医药,2020,27(11):179-182.
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