摘要
目的:建立骨科Ⅰ类切口手术预防性使用抗菌药物的量化评价体系,为科学评价该类手术抗菌药物预防使用的合理性提供参考。方法:以《抗菌药物临床用指导原则(2015版)》、相关药品说明书、相关指南与文献为依据,由相关科室专家共同商讨制定骨科Ⅰ类切口手术预防性使用抗菌药物合理性评价标准。采用层次分析法(AHP)对评价标准的各项指标进行赋权,并运用加权逼近理想解排序法(TOPSIS)对北京大学人民医院2019年9月1-30日的3个骨科科室的120例Ⅰ类切口手术患者的归档病例进行回顾性分析和合理性评价。结果:建立的评价体系包括4个一级指标(用药指征、用法用量、给药时机、其他因素)和12个二级指标,二级指标中权重占比较高的有适应证、药品选择及术前给药时机(权重分别为0.209、0.140、0.117)。在纳入的120份病例中,用药合理的占30.83%,基本合理的占47.50%,不合理的占21.67%。采用AHP-TOPSIS法所得评价结果与实际情况相符。结论:基于AHP-TOPSIS法建立的Ⅰ类切口手术预防使用抗菌药物合理性评价的方法,可将多个指标结合起来对用药合理性进行量化评估。该方法切实可行、操作性强、评价结果可量化,具有较广泛的适用范围。
OBJECTIVE:To establish quantitative evaluation system of the prophylactic use of antibiotics in orthopedic typeⅠincision surgery,and to provide reference for evaluating the rational prevention use of antibiotics in this type surgery scientifically.METHODS:Based on the Guidelines of Clinical Use of Antimicrobial Agents(2015 edition),drug instructions,related guidelines and references,experts from relevant departments jointly discussed and formulated the evaluation criteria for the rationality of the use of antibiotics in typeⅠincision in orthopedic surgery.AHP method was used to assign the weights for various indexes of evaluation criteria;TOPSIS method was used to retrospectively analyze and evaluate the rationality of 120 cases of typeⅠincision surgery from 3 orthopedic departments in Peking University People’s Hospital during Sept.1st-30th,2019.RESULTS:Established evaluation system included 4 primary indicators(medication indication,usage and dosage,medication timing,other factors)and 12 secondary indicators.Among the secondary indicators,indications,drug selection and timing of preoperative administration were the most important(weights were 0.209,0.140,0.117).Among 120 cases,30.83%of drug use were reasonable,47.50%were basically reasonable and 21.67%were unreasonable.Evaluation results obtained by AHP-TOPSIS were consistent with the actual situation.CONCLUSIONS:The rationality evaluation method of prophylactic use of antibiotics in typeⅠincision surgery based on AHP-TOPSIS method can quantitatively evaluate the rationality of drug use by combining multiple indicators.The method is feasible,operable,and the evaluation results can be quantified,which has a wide range of application.
作者
刘一
梁馨玉
宋佳伟
刘悦
胡蕾
侯珂露
司霞
赵美
王文沛
刘思鲁
黄琳
刘盈
封宇飞
LIU Yi;LIANG Xinyu;SONG Jiawei;LIU Yue;HU Lei;HOU Kelu;SI Xia;ZHAO Mei;WANG Wenpei;LIU Silu;HUANG Lin;LIU Ying;FENG Yufei(Dept.of Pharmacy,Peking University People’s Hospital,Beijing 100044,China;Clinical Pharmacy Center,Bozhou Municipal People’s Hospital,Anhui Bozhou 236800,China;Dept.of Medical Affair,Peking University People’s Hospital,Beijing 100044,China)
出处
《中国药房》
CAS
北大核心
2021年第5期623-629,共7页
China Pharmacy
基金
北京市自然科学基金资助项目(No.7192218)
北京大学人民医院研究与发展基金资助项目(No.RDY2019-39)。
