采用综合干预措施规范Ⅰ类切口手术预防使用抗菌药物的效果评价

Evaluation of the Effect of Comprehensive Intervention on Specification of Antibiotics Used for TypeⅠ Incision Operation

目的:为临床合理使用抗菌药物提供参考。方法:采用回顾性调查方法,选取2011年1-3月骨科手术、甲状腺手术、乳腺手术、疝气修补术4种Ⅰ类切口手术出院病例为干预前组,2013年1-3月Ⅰ类切口手术出院病例为干预后组,评价实施综合干预措施的效果。结果:实施综合干预后,Ⅰ类切口手术预防使用抗菌药物的多项指标有了明显改变;抗菌药物使用率由干预前的100%下降为干预后的65.77%(P<0.05)、药物选用合理率由干预前的24.91%上升为干预后的95.43%(P<0.05)、用药时机合理率由干预前的19.42%上升为干预后的98.63%(P<0.05)、用药时间合理率由干预前的2.91%上升为干预后的84.02%(P<0.05)。结论:采用综合干预措施能有效提高医院Ⅰ类切口手术预防使用抗菌药物的合理水平,但仍需进一步优化综合干预措施,加大综合干预力度,使抗菌药物的应用更趋合理。

OBJECTIVE：To provide reference for the rational use of antibiotics in the clinic. METHODS：By retrospective survey method,discharged medical records for 4 kinds of type Ⅰincision surgery as orthopedic surgery,thyroid surgery,breast surgery and hernia neoplasty were selected during Jan.-Mar. 2011 as pre-intervention group;the discharged medical records for typeⅠ incision surgery were selected during Jun.-Mar. 2013 as post-intervention group to evaluate the effects of the implementation of comprehensive intervention. RESULTS：After the implementation of comprehensive intervention,a number of indicators for prophylactic application of antibiotics had obvious changes,and the utilization ratio of antibiotics for prophylactic use decreased from 100%before intervention and 65.77% after intervention（P〈0.05）. The reasonable rate of drug selection increased from 24.91% before intervention to 95.43% after intervention（P〈0.05）;that of medication timing increased from 19.42% to 98.63% after intervention（P〈0.05）;that of medication time increased from 2.91% before intervention to 84.02% after intervention（P〈0.05）;that of prophylactic application of antibiotics in typeⅠ incision operation were improved on the whole. CONCLUSIONS：The comprehensive intervention can effectively improve reasonable prophylactic application of antibiotics in typeⅠ incision operation. But it is still required to further optimize comprehensive intervention measure and strengthen comprehensive intervention so as to promote rational use of antibiotics.