滨湖医院骨科Ⅰ类切口围术期预防使用抗菌药物的干预效果

Intervention Efficacy on Perioperative Use of Prophylactic Antibacterials in Patients Undergoing Type Ⅰ Incision Orthopedic Operation in Binhu Hospital

目的：探讨合肥市滨湖医院（以下简称＂我院＂）骨科Ⅰ类切口围术期预防使用抗菌药物的合理性及干预措施的实施效果。方法：选取干预前（2011年9月—2012年2月）的317例及干预后（2012年9月—2013年2月）的325例骨科Ⅰ类切口患者,比较其抗菌药物使用情况。结果：通过综合干预,预防使用抗菌药物的患者比例显著下降,由干预前的83.28%下降到干预后的54.15%（P〈0.05）;术前0.5~2.0 h给药率显著升高,由干预前的17.05%提高到干预后的90.91%（P〈0.05）;预防使用抗菌药物时间≤24 h的比例由干预前的33.33%提高到干预后的55.11%（P〈0.05）;用药指征合理率显著提高,手足骨科、创伤骨科、关节骨科用药指征合理率均达到100.00%;抗菌药物品种选择合理率显著上升。结论：我院对骨科Ⅰ类切口围术期预防使用抗菌药物的干预措施有效、可行,明显提高了我院骨科Ⅰ类切口围术期抗菌药物预防使用的合理性。

OBJECTIVE：To explore the rationality of and the intervention efficacy on the perioperative use of prophylactic antibacterials in patients undergoing orthopedic type I incision operation in Hefei Binhu Hospital （ hereinafter referred to as ＂our hospital＂ ）. METHODS ： The perioperative use of prophylactic antibacterials in patients undergoing orthopedic type I incision operation in our hospital from Sept. 2011 to Feb. 2012 （before intervention） vs. from Sept. 2012 to Feb. 2013 （after intervention） was analyzed contrastively. RESULTS： After intervention as compared with before intervention, the rate of perioperative use of prophylactic antibacterials intervention decreased from 83.28% to 54. 15% （P 〈 0.05） ; the rate of patients receiving antibacterials within 0.5-2.0 hours before the surgery increased significantly from 17.05% to 90. 91% （P 〈 0.05 ） ; the rate of the patients with perioperative use of prophylactic antibacterials for a duration of ~〈 24 hrs increased from 33.33% to 55.11% （P 〈 0.05 ） ; The rates of rational indications for drug use have all improved significantly, reaching 100.00% in Department of Extremity Orthopedics, Department of Orthopedics and Trauma and Department of Articular Orthopedics. The rate of rational choice of antibacterials has increased significantly. CONCLUSIONS： The intervention on the perioperative use of prophylactic antibacterials in patients undergoing orthopedic type I incision operation is effective and feasible and it has greatly improved the rationality in the perioperative use of prophylactic antibacterials.