管理前后清洁手术预防性用抗菌药物的横断面对比分析

ANALYSIS ON ANTIMICROBIAL PROPHYLACTIC USAGE IN PERIOPERATINAL PERIOD OF CLEAN SURGICAL OPERATIONS BEFORE AND AFTER MANAGEMENT

目的 探索清洁手术围手术期预防性应用抗菌药物的情况及抗菌药物监管的有效途径,促进抗菌药物的合理应用。方法 采用回顾性横断面调查方法,对该院2009年9月（抗菌药物专项整治活动前）和2012年8月（抗菌药物专项整治活动后）乳腺科、普通外科、骨科清洁手术围手术期预防性应用抗菌药物情况进行统计分析。结果 通过加强医院监管,清洁手术围手术期抗菌药物使用率从2008年8月的99.02%下降至2012年8月22.33%;选用药物品种合理率从61.11%上升至91.76%,术前0.5～2h内用药率从37.78%上升至95.29%;平均术后用药时间从4.03d缩短至不超过24h;用药合理率从21.11%升高至84.44%。结论 通过进行围手术期抗菌药物应用严格监管,可以明显提高抗菌药物应用的合理性。

Objective To study antimicrobial prophylactic usage in clean surgical operations and investi- gate management of antimicrobial usage, so as to promote rational use of antimicrobial angents. Methods Cross-sectional study was carried out on the rationality of antimicrobial application in patients at breast surgery ,general surgery and orthopedics surgery depanments in August, 2009 （before Special rectification activities of antimicrobial agents） and August,2012（after Special rectification activities of antimicrobial a- gents）. Results Through performing management of antimicrobial application agents, preoperative antimi- crobial prophylactic application rate in patients undergoing aseptic operation decreased from 99.02%in au- gust, 2009 to 22.33 %in august, 2012 ;the rate of using rational kind antimicrobial agents increased from 61. 11% to 91.76% ,0.5-2h of antimicrobial agents used rate before the operation increased from 37.78% to 95.29% ; the time of using antimicrobial agents after medication decreased from 4.03 days to less than 24 hours, Rational application rate increased from 21.11% to84.44%. Conclusion Through education of rational use of antimicrobial agents, Reinforcing management of antimicrobials can improve the rationality of prophylactic use.