技术干预对3种外科手术围术期预防性应用抗菌药物合理性的影响

Effect of Technical Intervention on Perioperative Use of Prophylactic Antibacterials in Patients Undergoing Three Different Surgeries

目的:配合卫生部抗菌药物临床应用专项整治活动,研究技术干预对外科手术预防性应用抗菌药物合理性的影响。方法:对某三级甲等医院闭合性股骨骨折复位内固定术、乳腺肿物切除术和子宫下段剖宫产术3种手术围术期预防性应用抗菌药物情况作基线调查,随后采取技术干预措施,对干预前后抗菌药物的合理用药综合评分、术后预防用药时间、金额占比、使用种类等指标进行比较分析。结果:技术干预后,围术期预防性应用抗菌药物的多项指标均得到明显改善。结论:技术干预有助于提高围术期预防性应用抗菌药物的合理性,但包括住院天数和住院金额等其他重要医疗指标的变化应当引起高度重视。

OBJECTIVE：To study the effect of technical intervention on rational use of antibacterials in response to the special rectification activities initiated by the Ministry of Health on clinical use of antibiotics.METHODS： We conducted a baseline survey on the perioperative use of antibiotics in patients undergoing closed femoral fracture reduction and internal fixation,resection of the breast neoplasm or cesarean section of lower uterine segment in a three-A level hospital and then took technical intervention measures on the use of antibiotic,with indexes such as comprehensive score of rational use of antibiotics,time of preventive use of antibiotics postoperatively,proportion of consumption sum,categories of antibiotics etc before and after the intervention analyzed comparatively.RESULTS： After technical intervention,many indexes of prophylactic use of antibiotics have improved significantly.CONCLUSION： Technical intervention helps to improve the rationality of prophylactic use antibiotics;however,great importance should be attached to the change of some important medical indexes including hospital stay and hospitalization cost.