3种Ⅰ类切口手术抗菌药物使用的干预效果分析

Intervention Efficacy on Perioperative Use of Prophylactic Antibiotics in Patients Undergoing Type Ⅰ Incision Operations

目的：评价河南中医学院第三附属医院实施抗菌药物临床应用专项整治活动对3种Ⅰ类切口手术（甲状腺次全切除术、乳腺包块切除术、腹股沟疝修补术）围术期预防性使用抗菌药物的干预效果.方法：抽取该院2010年9-10月、2013牟9-10月全部甲状腺次全切除术、乳腺包块切除术、腹股沟疝修补术出院患者病历共410份,对患者的基本信息和用药情况进行统计分析.结果：2010年9-10月200例患者中,预防性使用抗菌药物者占96.50％;术前0.5～ 2h使用抗菌药物者占3.63％;术后≤24h使用抗菌药物者占1.55％,术后＞24h使用抗菌药物者占98.45％;单一用药者占83.94％,联合用药者占16.06％.2013年9-10月210例患者中,预防性使用抗菌药物者占17.10％;术前0.5～2h使用抗菌药物者占91.67％;术后≤24h使用抗菌药物者占80.56％,术后＞24h使用抗菌药物者占19.44％;单一用药者占100.00％,无联合用药情况.结论：通过3年抗菌药物临床应用专项整治活动,该院Ⅰ类切口手术预防性使用抗菌药物的合理率明显提高.

OBJECTIVE：To evaluate the intervention efficacy of the special rectification activities on perioperative use of prophylactic antibiotics in patients undergoing type Ⅰ incision operations （subtotal resection of thyroid,breast mass excision or inguinal hernia repair surgery） in The Third Affiliated Hospital of Henan College of Traditional Chinese Medicine.METHODS：A total of 410 discharged medical records of the patients undergoing subtotal resection of thyroid,breast mass excision or inguinal hernia repair surgery during 2010 and Sept.-Oct.period of 2013 in our hospital were analyzed statistically regarding patients＇ basic information and medication.RESULTS：Of a total of 200 cases in 2010,prophylactic use of antibiotics was noted in 96.50％ ; the antibiotics were used 0.5～ 2 h before surgery in 3.63％,≤24 h after surgery in 1.55％ and ＞ 24 h after surgery in 98.45％,singly in 83.94％ versus in drug combination in 16.06％.Of a total of 210 cases during Sept.-Oct.period of 2013,prophylactic use of antibiotics was noted in 96.50％ ; the antibiotics were used 0.5 ～ 2 h before surgery in 80.56％,≤24 h after surgery in 17.10％ and ＞ 24 h after surgery in 19.44％,singly in 100％ versus in drug combination in none.CONCLUSIONS：Due to the special rectification activities over three years on clinical use of antibiotics,the rational rate of perioperative use of prophylactic antibiotics in patients undergoing type Ⅰ incision operation in our hospital has improved significantly.