| 马聪,王伟,严非.我国围手术期抗菌药物使用管理政策效果分析——基于分段回归分析[J].中国药事,2023,(2):215-220 |
| 我国围手术期抗菌药物使用管理政策效果分析——基于分段回归分析 |
| Analysis on the Eff ect of Management Policy on the Perioperative Antimicrobial Use in China: Based on Segmented Regression Analysis |
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| DOI：10.16153/j.1002-7777.2023.02.014 |
| 中文关键词: 抗菌药物 围手术期 政策效果 分段回归 管理政策 |
| 英文关键词: antimicrobial perioperative policy eff ect segmented regression management policy |
| 基金项目:国家自然科学基金面上项目(编号 81861138050) |
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| 中文摘要: |
| 目的：梳理我国围手术期抗菌药物管理政策，分析其管控效果，为完善我国围手术期抗菌药物使用管理提供参考。方法：按颁布时间梳理所收集的围手术期抗菌药物管理政策，运用分段回归方法分析全国抗菌药物临床应用监测网中心单位I类切口手术预防使用抗菌药物使用率。结果：我国围手术期抗菌药物使用管理政策经历起步、专项整治和强化巩固三个阶段，逐步发展完善。I类切口手术预防使用抗菌药物的使用率由96.9%下降至38%，在专项整治阶段瞬时显著变化(β2=-22.89，P=0.02)且持续下降 (β3=-10.22，P=0.022)，在强化巩固阶段趋势较上一阶段显著放缓(β5=10.08，P=0.025)，且无显著变化趋势(β1+β3+β5=-0.62，P=0.399)。结论：我国围手术期抗菌药物管理政策逐步发展完善，专项整治阶段的政策管控效果最为显著，今后可通过加强行政干预、进行专项知识技能培训等方式，加强围手术期预防用抗菌药物管理，进一步提高围手术期预防使用抗菌药物的合理性。 |
| 英文摘要: |
| Objective: To sort out the perioperative antimicrobial management policies in China and analyze the eff ect of the control policy to provide a reference for improving the management of perioperative antimicrobial use in China. Methods: The collected antimicrobial management policies were analyzed according to the time of promulgation, and the rate of preventive use of antimicrobial for class I incisional surgery in the central units of the National Clinical Application Monitoring Network of Antimicrobial was analyzed using segmented regression methods. Results: China's perioperative antimicrobial management policy has gone through three phases: starting phase, special rectification phase, and strengthening consolidation phase, and has gradually developed and improved. The utilization rate of antimicrobial preventive use for class I incisional procedures decreased from 96.9% to 38%, with a transient signifi cant change (β2=-22.89, P=0.02) and continuous decrease (β3=-10.22, P=0.022) during the special rectifi cation phase, and a signifi cant trend slowdown (β5=10.08, P=0.025) during the strengthening consolidation phase compared to the previous phase, with no signifi cant change trend (β1+β3+β5=-0.62, P=0.399). Conclusion: China's perioperative antimicrobial management policy has been gradually developed and perfected, and the policy control eff ect of the special rectifi cation phase is the most signifi cant. In the future, we can strengthen the management of perioperative preventive use of antimicrobials by strengthening administrative interventions and conducting special knowledge and skills training to further improve the rationality of perioperative preventive use of antimicrobials. |
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