我院Ⅰ类切口手术抗菌药预防应用专项整治前后使用情况分析

Comparative Analysis of Antimicrobial Prophylaxis in Type I Incision before and after Antimicrobial Drug Special Rectification in Our Hospital

目的：通过对比专项整治前后我院Ⅰ类切口手术抗菌药预防使用情况,考察我院Ⅰ类切口手术抗菌药使用改进情况。方法：从整治前2011年5-12月、整治中2012年5-12月和整治后2013年5-12月中每月随机抽取100份Ⅰ类切口手术病例,对抗菌药预防使用情况进行统计和对比分析。结果：专项整治后,Ⅰ类切口手术抗菌药预防性使用率从100%下降至28%,其中卫计委强调的7类手术（腹股沟疝修补术、甲状腺疾病手术、乳腺疾病手术、关节镜检查术、颈动脉内膜剥脱术、颅骨肿物切除术和经血管途径介入诊断术）抗菌药预防性使用率降至11%,抗菌药选用更加合理,药物使用时机时程、用法用量不合理率明显降低,联合用药现象显著减少。结论：专项整治成效显著,Ⅰ类切口手术抗菌药预防使用合理性得到明显改善。

Objective：To investigate the improvement in antibiotics use in our hospital by comparing the prophylactic application of antibiotics in type I incision before and after antimicrobial drug special rectification. Methods：The medical records of 100 hospitalized patients undergoing I incision respectively from May to December in 2011 （before the rectification）, from May to December in 2012 （ during the rectification） and from May to December in 2013 （ after the rectification） were withdrawn randomly. The prophylactic application of antibiotics was statistically and comparatively analyzed. Results： After the antimicrobial drug special rectification, the prophylactic application rate of antibiotics was reduced from 100% to 28%, and in 7 kinds of operations stressed by the National Health and Family Planning Commission （ inguinal hernia repair, thyroid disease, breast disease, arthroscopy, carotid endarterectomy, skull tumor resection and endovascular interventional diagnosis） , the prophylactic use rate of antimicrobial drugs was reduced to 11%. The variety choice of antibiotics in type I incision was more reasonable. The irrationality rate of medication time and course was decreased obviously, and the accuracy of dosage and usage was improved significantly. The combination of antibiotics was also notably decreased. Conclusion：The antimicrobial drug special rectification is effective, which can significantly improve the prophylactic application rationality of antibiotics for type I incision in our hospital.