腰椎后路减压融合术Ⅰ类切口抗菌药物使用的干预效果分析

Intervention effect of antibiotics used in typeⅠincision of lumbar posterior decompression and fusion

目的评价干预措施对腰椎后路减压融合术Ⅰ类切口抗菌药物使用的有效性和可行性。方法按随机数字表法抽取河南省洛阳正骨医院医院信息管理系统中腰椎后路减压融合术Ⅰ类切口手术出院病历360份,分为对照组(2016年1—9月)和干预组(2017年1—9月),每组各180例。干预方法采取建立健全机构和制度、宣传教育、加强审方系统信息化管理和实施监督等措施,并对干预前后抗菌药物使用情况进行统计分析。结果与对照组相比,干预组抗菌药物术前给药时机正确率由80.6%上升至93.3%,用药疗程由(4.37±1.54)d缩短至(3.43±1.19)d,品种选择正确例数由133例上升至178例,抗菌药物费用由(1136.50±603.34)元下降至(866.78±377.96)元,均差异有统计学意义(P<0.05),两组间手术部位感染发生率差异无统计学意义(P>0.05)。结论干预措施对促进腰椎后路减压融合术Ⅰ类切口抗菌药物的合理使用具有有效性、可行性。

Objective To evaluate the effectiveness and feasibility of interventions for the use of antibiotics in typeⅠincision in posterior decompression and fusion of lumbar spine.Methods According to the random number table method,360 discharged patients who underwent typeⅠincision of lumbar posterior decompression and fusion were selected from the hospital information management system of Luoyang Orthopedic Hospital of Henan Province and were divided into control group(January-September 2016)and intervention group(January-September 2017),with 180 cases in each group.During the course of the intervention,a variety of intervention methods were adopted,such as establishing and improving institutions and systems,publicity and education,strengthening the informatization management of the trial party system and implementing supervision.The use of antibiotics before and after the intervention was analyzed statistically.ResultsCompared with the control group,the timing accuracy of preoperative administration of antibiotics increased from 80.6%to 93.3%in the intervention group,the average duration of treatment decreased from(4.37±1.54)days to(3.43±1.19)days,and the number of correct selection of antibiotics increased from 133 to 178,the average cost of antibacterial decreased from(1136.50±603.34)yuan to(866.78±377.96)yuan,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of surgical site infection between the two groups(P>0.05).Conclusion Interventions are effective and feasible in promoting the rational use of antibiotics in typeⅠincision of posterior decompression and fusion of lumbar spine.