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目的:探讨采用世界卫生组织倡导的“监测-培训-计划”(MTP)模式对我院血管介入手术围术期抗菌药物干预的效果。方法:以我院2010年第1季度86例血管介入手术作为调研样本,通过MTP模式对心内科血管介入手术围术期抗菌药物的应用情况进行干预,经过4轮MTP循环,取2011年第1季度95例血管介入手术作为干预后的最终样本,比较干预前、后的效果。结果:经过4轮干预,抗菌药物应用率从干预前的100%下降到干预后的84.2%(P<0.05);用药品种前3位由头孢美唑钠、头孢哌酮/他唑巴坦、头孢孟多酯钠更换为头孢唑林、头孢硫脒、头孢美唑钠;术后24h停药病例由0升高到91.3%(P<0.05);平均住院时间由12.6d下降到11.8d;平均总药品费用由8639.8元下降到6825.2元;平均抗菌药物费用由1814.64元下降到84.5元。结论:运用MTP模式对我院心内科血管介入手术围术期抗菌药物的应用进行管理,明显提高了抗菌药物应用的合理性与卫生经济效益。
Objective: To investigate the effect of perioperative antibiotic intervention on vascular interventional surgery in our hospital with the “Monitoring - Training - Planning” (MTP) model advocated by the World Health Organization. Methods: Totally 86 cases of vascular intervention in our hospital in the first quarter of 2010 were selected as the research samples. The MTP model was used to intervene the perioperative application of antimicrobial agents in the cardiovascular interventional procedure. After 4 rounds of MTP cycles, Quarterly 95 cases of vascular intervention as the final sample after intervention to compare the effect of intervention before and after. Results: After 4 rounds of intervention, the application rate of antibacterials decreased from 100% before intervention to 84.2% after intervention (P <0.05). The top three drugs were cefmetazole sodium, cefoperazone / tazobactam, Cefadroxil sodium was replaced by cefazolin, cefathiamidine and cefmetazole sodium; the number of withdrawal cases increased from 0 to 91.3% (P <0.05) after 24 hours of operation; the average length of stay decreased from 12.6 days to 11.8 days; The average total drug costs decreased from 8,639.8 yuan to 6,825.2 yuan; the average cost of antimicrobial drugs decreased from 1814.64 yuan to 84.5 yuan. Conclusion: The application of MTP model to the management of perioperative antibiotics in cardiovascular interventional surgery in our hospital significantly improves the rationality of antibacterials application and economic benefits of health.