Ⅰ类切口手术预防用抗菌药物分析及干预研究

Antibiotic prophylaxis for typeⅠincision surgery and study on interventions

目的了解Ⅰ类切口围手术期预防用药情况及干预效果,以降低手术切口感染的发生。方法调查分析2010年4月-2012年4月每年4月份和10月份共255例Ⅰ类切口手术患者预防性使用抗菌药物情况。结果全院手术科室基本能将抗菌药物带入手术室使用,带入使用率为99.22%;干预后预防用药使用天数及使用率明显减少,2010年4、10月、2011年4、10月和2012年4月使用天数分别为4.07、4.18、4.0、0.69、0.27d;使用率分别为100.0%、100.0%、97.9%、38.8%、10.4%;干预后抗菌药物品种选择合理性有明显提高,符合规范数分别为8、10、9、48、66例,规范率分别为18.6%、20.4%、19.1%、97.9%、98.5%。结论综合性干预措施可显著降低抗菌药物的使用率,缩短使用时间,优化抗菌药物使用种类;干预措施有效可行,多部门联动,综合干预,持续改进是取得成效的关键。

OBJECTIVE To investigate the status of prophylactic use of antibiotics during perioperative period of typeⅠincision surgery and observe the effects of interventions so as to reduce the incidence of surgical incision infections.METHODS Totally 255cases of patients who underwent the typeⅠincision surgery from Apr 2010 to Apr 2012were enrolled in the study,then the prophylactic use of antibiotics in every Apr and Oct during this period was investigated.RESULTS The antibiotics could be brought and used in the operating room,the utilization rate was 99.22%;the duration of antibiotics prophylaxis and the utilization rate were significantly reduced after the interventions were implemented,the duration of use of antibiotics was 4.07days in Apr 2010,4.18days in Oct 2010,4.0 days in Apr 2011,0.69 day in Oct 2011,0.27day in Apr 2012;the utilization rates were 100.0%, 100.0%,97.9%,38.8%,and 10.4%,respectively.The rationality of use of antibiotics was significantly improved after the interventions were implemented;the number of the cases conforming to the specification were 8,10,9,48,and 66,respectively,and the rates were 18.6%,20.4%,19.1%,97.9%,and 98.5%,respectively.CONCLUSIONComprehensive interventions can decrease the utilization rate of antibiotics,shorten the time of drug therapy,and optimize the use of antibiotics;the feasible and effective interventions,multi-sector cooperation,and comprehensive interventions,and continuous improvement are the keys to achieve effectiveness.