Ⅰ类手术切口抗菌药物使用干预效果分析

Effects of interventions to antibiotic prophylaxis during perioperative period of type Ⅰ incision surgery

目的为促进Ⅰ类清洁手术预防性抗菌药物的合理使用,对Ⅰ类手术切口抗菌药物使用进行干预,并对干预工作的效果进行评价。方法对2011年299例干预前(1-6月份)247例与干预后(7-10月份)97例甲状腺和乳腺切口患者手术前后抗菌药物使用种类、时间等进行监测,并进行统计分析。结果 299例患者中未出现切口感染;干预前仅1例患者术前未使用抗菌药物,占0.40%,干预后术前未使用抗菌药物患者达到16例,占32.69%;干预前患者于术后0、≤24、≥96h使用抗菌药物分别占0.81%、8.94%、66.26%,干预后分别占45.71%、31.43%、5.71%。结论实现了Ⅰ类切口手术零感染,且抗菌药物使用得到明显的好转,说明对医护人员进行教育培训并开展目标性监测,是控制Ⅰ类切口手术围手术期预防性使用抗菌药物的有效方法。

OBJECTIVE To intervene antibiotic prophylaxis for the type I incision surgery and evaluate the effects of interventions so as to promote the reasonable prophylactic use of antibiotics during perioperative period of type I clean surgery. METHODS Totally 299 （from Jan to Jun 2011, before the intervention） cases and 97 （from Jul to Oct, after the intervention） cases who underwent the thyroid or breast incision surgery were recruited in the study, then the types of antibiotics used before and after the surgery and the time of use of antibiotics were monitored and statistically analyzed. RESULTS Among the 299 cases of patients, the incision infections did not occur. Before the intervention, only one case did not use antibiotics before the surgery , accounting for 0.40~ after the intervention, 16 cases did not use antibiotics before the surgery, accounting for 32. 69%. Before the intervention,the constituent ratios of the patients who used antibiotics at 0 hour, less than 24 hours, and more than 96 hours after the surgery were 0. 81~, 8. 94~, and 66. 26%, respectively; after the intervention, the constituent ratios were 45.71%, 31.43 %, and 5.71 %, respectively. CONCLUSION The incidence rate of incision infections during perioperative period of type incision surgery is zero, and the use of antibiotics is significantly improved, indicating that to conduct the training for medical staff and carry out the targeted monitoring is an effective way to control the prophylactic use of antibiotics during the perioperative period of type I incision surgery.