综合干预对人工关节置换术围术期抗菌药物应用的影响研究

Influence of comprehensive intervention on use of antibiotics during perioperative period of artificial joint replacement surgery

目的探讨综合干预对关节置换术预防性使用抗菌药物的影响,为抗菌药管理决策提供参考依据。方法回顾性分析医院2012年1-12月（干预前）和2014年1月~12月（干预后）关节置换术患者各176例,对其围术期预防使用抗菌药物进行合理性评价。结果与干预前比较,干预后抗菌药物品种选择、给药时机、溶媒量、给药疗程、联合用药有明显改善,差异有统计学意义（P〈0.05）,但抗菌药物使用强度和疗程仍较高。结论综合干预可改善医院关节置换术预防性使用抗菌药物情况,但仍然存在抗菌药物使用强度大,术后维持时间过长的现象,有待进一步干预和规范。

OBJECTIVE To explore the influence of comprehensive intervention on antibiotics prophylaxis for joint replacement surgery so as to provide guidance for management of antibiotics. METHODS Totally 176 patients who underwent the joint replacement surgery from Jan 2012 to Dec 2012 （before the intervention） and 176 patients who underwent the joint replacement surgery from Jan 2014 to Dec 2014 （ after the intervention） were retrospectively analyzed, and the rationality of use of antibiotics during the perioperative period was evaluated. RESULTS The choice of antibiotics, drug administration timing, solvent content, treatment course, and combined use of antibiot- ics were significantly improved after the intervention（P〈0.05）. However, the intensity of use of antibiotics and treatment course remained high. CONCLUSION The comprehensive intervention can improve the status of antibiotic prophylaxis for the joint replacement surgery, however, the intensity of use of antibiotics remains great, the post- operative maintenance time is prolonged, and it is necessary to take further interventions.