摘要
目的基于属性层次模型(attribute hierarchical model,AHM)探讨骨科手术患者预防性使用抗菌药物的合理性。方法构建AHM对2019年2月至2024年10月亳州市人民医院骨科160例手术患者的住院病历进行回顾性分析。结果骨科手术预防性使用抗菌药物不合理类型主要为药物剂量41.25%(66/160)、用药疗程36.88%(59/160)、用药前皮肤试验34.38%(55/160),其中用药疗程>48 h的占36.88%(59/160)、药物剂量中头孢呋辛成人单次给药>1.5 g,儿童单次给药>50 mg·kg^(-1)的占31.25%(50/160)及用药前皮肤试验中头孢呋辛皮肤试验占28.75%(46/160)。MRS≥90分共64例(40.00%),85分≤MRS<90分共43例(26.88%),80分≤MRS<85分共30例(18.75%),MRS<80分共23例(14.38%)。结论骨科手术患者预防性使用抗菌药物合理性尚可,仍有较大提升空间,需在药物剂量、用药疗程及用药前皮肤试验方面进一步加强管理。
Objective To investigate the rationality of prophylactic antibiotic use in patients undergoing orthopedic surgery based on the attribute hierarchy model(AHM).Methods The AHM was constructed to conduct a retrospective analysis of the inpatient medical records of 160 patients who underwent surgery in Department of Orthopedics,the People’s Hospital of Bozhou from February 2019 to October 2024.Results The types of unreasonable prophylactic use of antibacterial agents in patients undergoing orthopedic surgery mainly included drug dose(41.25%(66/160)),medication course(36.88%(59/160))and drug allergy test before medication(34.38%(55/160)).Among them,the proportion of treatment courses lasting more than 48 hours was 36.88%(59/160).For cefuroxime dosing,the proportion of adult single doses exceeding 1.5 g and pediatric single doses exceeding 50 mg·kg^(-1) was 31.25%(50/160).Additionally,the proportion of cefuroxime skin tests conducted before medication was 28.75%(46/160).Regarding the medical record score(MRS),64 cases(40.00%)had an MRS of≥90 points,43 cases(26.88%)had an MRS between 85 and 89 points,30 cases(18.75%)had an MRS between 80 and 84 points,and 23 cases(14.38%)had an MRS of<80 points.Conclusion The rationality of prophylactic use of antibacterial drugs for patients undergoing orthopedic surgery is acceptable,but there is still considerable room for improvement.Further management needs to be strengthened in terms of drug dosage,course of medication and drug allergy test before medication.
作者
卢腾飞
凡有非
张清
Lu Tengfei;Fan Youfei;Zhang Qing(Department of Pharmacy,The People’s Hospital of Bozhou,Bozhou 236800,China;Department of Arthroscopy and Sports Medicine,The People’s Hospital of Bozhou,Bozhou 236800,China)
出处
《中国药物应用与监测》
2025年第5期919-922,共4页
Chinese Journal of Drug Application and Monitoring
基金
亳州市重点研发计划项目(bzzc2023056)。
关键词
属性层次模型
骨科
抗菌药物
预防使用
合理性评价
Attribute hierarchy model
Department of orthopedics
Antibacterial drug
Prophylactic use
Rationality evaluation
