摘要目的 为妇科围术期预防性应用抗菌药物提供参考,建立妇科围术期抗菌药物预防使用合理性评价标准。 方法 以《抗菌药物临床应用指导原则》(2015版,简称《指导原则》)为基础,结合药品说明书、专家共识及指南等制定评价标准。对评价指标用层次分析法(analytic hierarchy process,AHP)赋予权重,结合逼近理想解排序方法(technique for order preference by similarity to ideal solution,TOPSIS)评价分析2021年5月—2022年4月随机抽取的在淮北市人民医院进行妇科手术的100份归档病例。 结果 5个一级指标和12个二级指标构成评价标准,适应症、术前用药时机、品种选择在二级指标中权重占比较高(权重分别为0.2352、0.2100、0.1562)。评价的100份病例中用药合理比例为40%,基本合理比例为35.0%,不合理比例为25.0%。 结论 目前该院尚存在妇科围术期抗菌药物预防性使用不合理现象,在提高妇科抗菌药物的合理性使用上应采取干预措施。基于AHP的TOPSIS评价方法可以量化评价结果,用于评价抗菌药物在围手术期预防使用的合理性。
Abstract：Objective To provide references for prophylactic application of antimicrobials during gynecological perioperative period, and to establish a set of rational evaluation criteria for prophylactic use of antimicrobials during gynecological perioperative period. Methods Based on the Guiding Principles for Clinical Application of Antibiotics (2015 edition), the evaluation criteria were formulated in combination with drug specifications, expert consensus and guidelines. 100 archival cases of gynecologicalsurgery randomly selected in Huaibei People’s Hospital from May 2021 to April 2022 were evaluated and analyzed by applying analytic hierarchy process (AHP) to assign weights to evaluation indicators and combining with the technique for order preference by similarity to ideal solution (TOPSIS) method. Results Five primary indexes and 12 secondary indexes constituted the evaluation criteria. Indications, preoperative medication timing and variety selection accounted for relatively high weights in the secondary indexes (the weights were 0.2352, 0.2100 and 0.1562 respectively). Among the 100 cases evaluated, the proportions of rational drug use, basically rational drug use and irrational drug use were 40%, 35.0% and 25.0% respectively. Conclusion At present, there still exists irrational prophylactic use of antibacterial drugs during gynecological perioperative period in this hospital. Intervention measures should be taken to improve the rational use of antibacterial drugs in gynecology. The TOPSIS evaluation method based on AHP can quantify the evaluation results, and it can be used to assess the rationality of prophylactic use of antibiotics during perioperative period.
桑翩翩, 李小东. 加权TOPSIS法评价妇科围术期预防性应用抗菌药物的合理性[J]. 实用预防医学, 2023, 30(8): 927-931.
SANG Pianpian, LI Xiaodong. Evaluation on the rationality of prophylactic use of antibiotics during gynecological perioperative period based on the weighted TOPSIS method. , 2023, 30(8): 927-931.
2023, Vol. 30 
