Ⅰ类切口手术患者围术期预防应用抗菌药物研究

Antibiotics prophylaxis during perioperative period of typeⅠincision surgery

目的探索Ⅰ类切口手术围术期预防应用抗菌药物管理方法,规范使用抗菌药物,降低手术切口感染率。方法制定干预方案,对甲状腺瘤、乳腺纤维瘤、腹外疝等Ⅰ类切口手术围术期预防应用抗菌药物实施干预的133例为干预组,将干预前一年同期108例患者作为对照组,检验干预效果。结果干预预防应用抗菌药物品种正确率由1.85%上升至96.24%;时机正确率由81.48%上升至95.49%;剂量正确率由0上升至98.00%;抗菌药物平均使用时间由每例平均6.42d下降至2.59d;平均住院费用由3 760.02元/例降至3 208.07元/例;抗菌药物费用由264.54元/例减少至27.11元/例;术后住院时间由8.13d/例减少至6.82d/例;切口甲级愈合率由97.22%上升至99.25%;两组病例均未出现医院感染。结论对Ⅰ类切口手术围术期预防应用抗菌药物实施干预,能有效规范抗菌药物预防应用,成效显著。

OBJECTIVE To explore the prophylactic use of antibiotics during the perioperative period of type Ⅰincision surgery so as to reasonably use antibiotics and reduce the incidence of surgical incision infections . METHODS The intervention programs were formulated ,totally 133 cases of thyroid tumors ,adenofibroma ,and abdominal hernia for whom the interventions were taken for the antibiotics prophylaxis during the perioperative period of type incision surgery were assigned as the intervention group , while 108 patients for whom the interventions were taken during the same period one year before the intervention group ,and the effects of the interventions were observed .RESULTS After the intervention programs were implemented , the rate of correct prophylactic use of antibiotics increased from 1 .85% to 96 .24% , the rate of correct timing for medication increased from 81 .48% to 95 .49% ,the rate of correct dosage increased from 0 to 98 .00% ;the median time of use of antibiotics dropped from 6 .42 days per case to 2 .59 days per case ,the mean hospitalization cost decreased from 3760 .02 yuan per case to 3208 .07 yuan per case ,the cost of antibiotics dropped from 264 .54 yuan per case to 27 .11 yuan per case;the postoperative hospitalization duration decreased from 8 .13 days per case to 6 .82 days per case;the grade A healing rate of incision increased from 97 .22% to 99 .25% ;the nosocomial infections occurred in neither of the two groups .CONCLUSION It is an effective way to take interventions to the antibiotics prophylaxis during the perioperative period of type I incision surgery so as to standardize the prophylactic use of antibiotics and achieve significant effectiveness .