Ⅰ类切口手术围手术期预防用抗菌药物干预前后对比分析

Rational Use of Antibiotics at Perioperative Period of Type Ⅰ Incision Operations Between A Comparison Pre-and Post-intervention

目的探讨干预前后医院甲状腺、乳腺手术、疝气修补术3种Ⅰ类切口手术围手术期预防用抗菌药物的合理性与干预措施实施的效果。方法选取实施干预前的2008年3月及干预后的2008年9月3种Ⅰ类切口手术出院病历,进行干预前后预防用抗菌药物合理性的对照研究。结果干预后抗菌药物使用率显著下降,由干预前100.00%下降为干预后60.47%(P<0.05);抗菌药物的合理使用率显著提高,由干预前0上升为干预后44.19%(P<0.05);不合理使用抗菌药物的现象明显改善;平均药费由2433.05元下降为1732.22元(P<0.05),平均抗菌药物费用由988.17元下降为81.25元(P<0.05)。结论医院采取的干预措施有效、可行,可显著提高抗菌药物的合理使用率,降低抗菌药物费用,为医院设计单病种临床路径及降低单病种费用提供依据。

OBJECTIVE To study the rational use of antibiotics at perioperative period of three types Ⅰ incision operations including thyroid surgery, breast surgery, repairing hernia surgery and survey the effect of the intervention measures. METHODS The data 05 medication of two patient groups in Mar 2008 （pre-intervention） and Sep 2008（post-intervention） were collected and compared. RESULTS The percentage of antibiotics use was much lower, from 100% pre-intervention to 60. 47% post-intervention （P〈0. 05）. There was a remarkable improvement on the rationality of antibiotics use, from 0 to 44. 19% （P〈0.05）. The reasons of the irrationally utilizing antibiotics pre-and post-intervention were significantly different. The average drug costs were remarkably decreased from 2433.05 yuan to 1732.22 yuan and the average antibiotics use from 988.17 yuan to 81.25 yuan （P 〈0.05） pre-and post-intervention. CONCLUSIONS The intervention measures are effective and feasible. This principle can contribute to improving the rational use of antibiotics, and decreasing the antibiotics costs. It can also provide a feasible and effective model for designing clinical pathway to reduce the cost.