腹腔镜胆囊切除术208例术后抗菌药物应用调查及经济学分析

    Investigation of postoperative antimicrobial application and economic analysis in 208 patients treated with laparoscopic cholecystectomy

    • 摘要: 目的:了解腹腔镜胆囊切除术后抗菌药物的应用情况,评价不同抗菌药物方案的经济性。方法:回顾性调查208例腹腔镜胆囊切除术病人,按照术后抗菌药物的使用品种划分出不同组别,对用药频率最高的3组用药方案的品种、用药疗程、用药金额进行统计分析,采用成本-效果分析法比较3组抗菌药物应用方案的成本-效果比值。结果:208例中共有18种给药方案并涉及10个品种,二代头孢菌素类和硝基咪唑类药物使用频率最高。抗菌药物使用频率最高的3组分别为A组(头孢呋辛)、B组(头孢呋辛+奥硝唑)、P组(头孢曲松+奥硝唑)。A组病人有效率97.26%,B组和P组有效率均为100.00%,3组抗菌药物有效率差异无统计学意义(P>0.05)。A组与B组抗菌药物成本差异有统计学意义(P<0.01),但A组与P组、B组与P组抗菌药物成本差异均无统计学意义(P>0.05)。假设抗菌药物价格下调10%,调整后3组成本差异有统计学意义(P<0.01),其中A组与B组调整后成本差异有统计学意义(P<0.01),但P组与A组、P组与B组调整后成本差异均无统计学意义(P>0.05)。结论:腹腔镜胆囊切除病例术后抗菌药物选用头孢呋辛、头孢曲松,或同时联用奥硝唑均安全有效。头孢呋辛用于腹腔镜胆囊切除术病例有很好的临床效果,为最佳方案。

       

      Abstract: Objective:To investigate the postoperative use of antimicrobials in patients treated with laparoscopic cholecystectomy(LC),and evaluate the economic effectiveness of different antimicrobial solutions.Methods:The clinical data of 208 patients treated with LC were retrospectively analyzed.The patients were divided into three groups according to the postoperative use of antimicrobials.The variety of drug,administration duration and administration cost in three kinds of the highest use frequency of antimicrobials were statistically analyzed.The ratio of cost to effectiveness between three solutions was compared using the cost-effectiveness analysis method.Results:Eighteen administration solutions(involving 10 varieties of drugs) in 208 cases were identified.The use frequency of the second generation cephalosporins and nitroimidazoles was the highest.The highest use frequency of antimicrobials in patients was the group A(cefuroxime),group B(cefuroxime and ornidazole) and group P(ceftriaxone and ornidazole).The effective rates in group A,B and P were 97.26%,100.00% and 100%,respectively,the differences of which between three groups were not statistically significant(P>0.05).The difference of the drug cost between group A and group B was statistically significant(P<0.01),but the differences of the drug cost between group A and group P,and between group B and group P were not statistically significant(P>0.05).After the antimicrobial drug price was downregulated by 10%,the difference of the drug cost between group A and group B was statistically significant(P<0.05),but the differences of the drug cost between group A and group P,and between group B and group P were not statistically significant(P>0.05).Conclusions:The postoperative uses of cefuroxime,ceftriaxone or combination with ornidazole in patients treated with LC are safe and effective.The postoperative use of cefuroxime is the best solution.

       

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