目的：了解抑酸制剂在外科的使用情况，进一步规范抑酸制剂的临床应用，探索临床药师干预临床辅助用药的模式。方法：全面调查干预前（2009—2011年）及干预后（2012年）3类切口手术（污染手术、清洁-污染手术、清洁手术）出院病例资料，对围术期抑酸制剂的使用情况进行对照分析。结果：经临床药师干预后，围术期预防性应用抑酸制剂在适应证、药物选择、用法与用量等方面的合理性均明显提高（ P＜0.05）；患者住院时间、抑酸制剂使用时间、抑酸制剂费用和住院药品总费用占住院总费用的比例均有所降低。结论：临床药师分析不合理用药情况，找到临床干预靶点，通过干预单病种围术期抑酸制剂治疗方案，将干预模式推广至其他单病种的药物治疗，并为临床药师参与并制定单病种临床路径提供了可行、有效的工作模式。%OBJECTIVE:To investigate the perioperative use of the acid-suppressive agents in surgical patients so as to standardize the clinical application of acid-suppressive agents, and to explore the clinical pharmacists'intervention model on the use of adjuvant drugs. METHODS: The medical records of the discharged patients undergoing operations ( contaminated surgery, aseptic-contaminated surgery, aseptic surgery ) before and after the intervention ( 2009-2011 vs.2012 ) were reviewed for comparative analysis regarding the use of acid-suppressive agents.RESULTS: The perioperative prophylactic use of acid-suppressive agents were significantly more rational in indications, drug selection, and usage and dosage after clinical pharmacists'intervention than before intervention ( P<0.05), and the hospital stay, administration duration of antacids, proportion of drug costs in total hospitalization costs were all decreased after intervention.CONCLUSIONS:Clinical pharmacists find out the clinical intervention targets by analyzing the irrational use of drugs.The intervention model on perioperative acid-suppressive therapy can be applied to drug use for other diseases and it provides feasible and effective working model for clinical pharmacists to be involved in the formulation of clinical pathway of single disease.
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