穆菁　蒋海华　郑郡

[摘要]目的 探讨分析宫腔镜围术期临床药师干预抗菌药物使用的效果。方法 在2016年11月～2017年4月于我院接受宫腔镜手术治疗的患者中选取符合条件的220例作为研究对象，并随机分为两组，其中110例患者使用抗菌药物接受临床药师干预，为观察组；另110例患者常规使用抗菌药物，无临床药师干预，为对照组。观察比较两组患者抗菌药物的使用率、药物选择合理率、用药疗程、用药疗程合理率等指标，分析宫腔镜围术期临床药师干预抗菌药物使用的效果。结果 观察组患者抗菌药物使用率较对照组患者显著降低，差异有统计学意义（P<0.05）；观察组患者药物选择合理率较对照组患者显著升高，差异有统计学意义（P<0.05）；观察组患者平均用药疗程较对照组患者明显缩短，差异有统计学意义（P<0.05）；观察组患者用药疗程的合理率较对照组患者显著升高，差异有统计学意义（P<0.05）。结论 宫腔镜围术期临床药师干预抗菌药物使用，在一定程度上提高了药物选择合理率、用药疗程合理率，降低了抗菌药物使用率，值得临床运用和推广。

[关键词]宫腔镜；围术期；抗菌药物；干预

[中图分类号] R969.3 [文献标识码] A [文章编号] 1674-4721（2017）08（a）-0129-03

[Abstractc]Objective To investigate the effect of clinical pharmacist intervention on the use of antibiotics during the perioperative period.Methods A total of 220 patients in our hospital were selected as the research object from November 2016 to April 2017，and were rangdomly divided into the following two groups.The observation group of 110 patients were treated with antibiotics for clinical pharmacist intervention，the control group were treated with conventionalantibiotics.The two groups of patients were observed and compared with the use rate of antimicrobial agents，the reasonable rate of drug selection，the reasonable rate of medication，and so on.Results The usage rate of antimicrobial drugs in the observation group was lower than that in the control group，the difference was statistically significant （P<0.05）；the rate of rational drug selection in the observation groupincreased was higher than that the control group，the difference was statistically significant （P<0.05）；the reasonable rate in the observation group was higher than that in the control group，the difference was statistically significant （P<0.05）.Conclusion Hysteroscopy perioperative clinical pharmacist intervention the use of antibiotics can improve the rational drug selection rate，drug treatment and reasonable rates，reduce the use rate of antibacterial drugs，which is worthy of clinical application and promotion.

[Key words]Hysteroscopy；Perioperative period；Antibiotics；Intervention

宮腔镜手术为微创手术[1]，在宫腔镜的直视下，该手术创伤小，直观且准确，在宫腔镜病变的诊断治疗中的作用得到广大医生和患者的认可，在临床上得以广泛开展和运用，但是宫腔镜经宫颈操作中若出现失误，仍存在于阴道内的大量潜在致病菌感染宫腔的风险，研究表明抗菌药物在围术期的合理使用有着相当重要的意义[2]，依据我国医疗机构现有的围术期抗菌药物使用标准如《抗菌药物临床应用指导原则》[3]、《卫生部办公厅关于抗菌药物临床应用管理有关问题的通知》[4]、《国家抗微生物治疗指南》[5]及《全国抗菌药物临床应用专项整治活动方案》[6]等，并未对抗菌药物在宫腔镜手术围术期的使用作出严格规范，广大医生在临床上应用抗菌药物时仍存在疑问[7]。……