手术部位感染目标性监测效果评价

Effect of target monitoring on surgical site infection:clinical evaluation

目的了解医院手术部位感染的相关因素、围手术期抗菌药物应用情况,评价采取干预措施后的控制效果。方法采用前瞻性调查方法,按预先设计好的表格内容,由医院感染管理专职人员每天对医院2009年5月至2010年5月的乳腺癌、胃及结肠手术的534例患者手术部位及相关危险因素进行评估并填写表格直至患者出院后30d。结果第1阶段手术部位感染率为0.72%,第2阶段感染率为0,其中Ⅰ、Ⅱ类切口感染率为0,Ⅲ类手术切口感染率为3.28%(P<0.01);围手术期抗菌药物第2阶段较第1阶段有了明显的规范,麻醉诱导期用药由第1阶段的2.17%提高到第2阶段的82.56%;术后使用抗菌药物<24h,由第1阶段的6.61%提高到第2阶段的30.23%;术后未使用抗菌药物由第1阶段的1.81%提高到第2阶段的8.14%;单种抗菌药物使用由第1阶段的30.07%提高到第2阶段的44.96%。结论手术部位感染目标性监测能有效降低手术部位感染的发生;抗菌药物的围手术期预防性应用有了明显规范。

OBJECTIVE To evaluate the intervening effect on nosocomial infection by investigating the risk factors of surgical site infection and the usage of perioperative antibacterial agents. METHODS Using the prospective monitoring method,professional infection management group filled in the self-designed survey including the surgical sites and the risk factors from May 2009 to May 2010.Data from 534 patients of breast cancer,gastric cancer or colon cancer were analyzed. RESULTS The surgical site infection rate of the 1st stage was 0.72%,and the 2nd stage was 0,Among the 1st stage,infection rate of the type Ⅰ incision and Ⅱ was 0.and type Ⅲ incision was 3.28%（P0.01）.The antibiotic usage in perioperative period was obviously normative.The usage during anesthesia induction increased from the 1st stage＇s 2.17% to the 2nd stage＇s 82.56%.The antibiotic usage after operation was less than 24h,increasing from 1st stage＇s 6.61% to 2nd stage＇s 30.23%.The rate without the usage of antibiotic increased from 1st stage＇s 1.81% to 2nd stage＇s 8.14%,while the single antibiotic usage increased from 30.07% to 44.96%. CONCLUSION Objective monitoring on surgical site infection can effectively reduce the infection rate.The preventive usage of antibiotics during perioperative period is obviously normative.