Ⅰ类切口手术围手术期抗菌药物预防性应用分析

Efficacy of management on perioperative antimicrobial prophylaxis in type Ⅰ incision operations

目的调查某院Ⅰ类切口手术预防性使用抗菌药物情况,评价其用药合理性及干预效果。方法采用回顾性调查方法,对该院外科2011年12月1日—2012年2月29日(干预后)Ⅰ类切口手术患者病历资料进行分析,并与2011年4月份资料(干预前)进行比较。结果干预后共调查612例Ⅰ类切口手术患者,其中112例(18.30%)使用了抗菌药物,均为术前30 min预防性用药;101例(90.18%)患者预防性使用抗菌药物时间≤24 h;共使用9种抗菌药物,其中5种属于第一代和第二代头孢菌素类;3例妇科手术患者为二联用药,其余(97.32%)均为单一用药。612例患者均未发生切口感染。与干预前比较,干预后Ⅰ类切口手术预防性使用抗菌药物更规范、合理。结论该院Ⅰ类切口手术围手术期预防性使用抗菌药物尚合理,基本达到卫生部的要求,但仍需持续改进,确保Ⅰ类切口手术抗菌药物预防性使用的规范化。

Objective To investigate the perioperative prophylactic use of antimicrohial agents in typeⅠ incision operations in a hospital, and evaluate the rationality and intervention efficacy of antimicrobial application. Methods A retrospective study was conducted, data of patients with type Ⅰ incision operations between December 1, 2011 and February 29, 2012 （post-intervention group） were analyzed and compared with that in April 2011 （pre-intervention group）. Results After intervention, a total of 612 cases of type I incision operations were surveyed, 112 （18. 30%） patients received antimicrobial agents within 30 minutes prior to incision; 101 （90. 18% ） patients used prophylactic antimicrobial agents ≤24 hours; 9 kinds of antimicrobial agents were used, 5 of which were the first and second generation cephalosporins; 3 patients with gynecological operations used two agents combined, the other patients all received single agent. No incision infection occurred among 612 patients. Compared with pre-intervention group, antimicrobial use in post-intervention group was more rational. Conclusion Perioperative antimicrobial prophylaxis in type I incision operation in this hospital is rational, and basically meets the requirement of the Ministry of Health, but it still needs improvement to make sure the standard application of antimierobial agents in type I incision operation.