骨科围手术期预防使用抗菌药物情况对比分析

Comparative analysis of perioperative antibacterial agents for prevention usage in department of orthopedics

目的通过对骨科围手术期预防用抗菌药物使用情况的对比分析,判断预防用抗菌药物使用情况有无反复。方法选取2013年360例及2014年426例骨科Ⅰ类切口手术患者,对其抗菌药物使用情况进行调查分析。结果 2014年较2013年在适应证的把握、药物选择、用法用量及术前给药时机上有明显改善,适应证把握的合理性由49.70%上升到91.49%,药物选择合理率由70.06%增加到100.00%,2014年用法用量也全部合理,术前给药时机合理率也由62.28%增长为98.94%,但2014年预防用药使用率与2013年相比差异无统计学意义(P>0.05),分别为46.39%和44.13%,均高于卫生部(现卫计委)的要求,术后用药时间过长的现象虽有所改善,但不合理率仍较高,两年总体评价结果比较,差异有统计学意义(P<0.05)。结论 2014年抗菌药物预防用药整体情况明显比2013年合理,说明2013年的整顿工作不仅没有反复,反而达到了常态的效果。但在预防用药的把握及用药时间等问题上仍需进一步加强管理和教育力度。

Objective To compare and analyze application of perioperative antibacterial agents for prevention usage in department of orthopedics, and to judge repetition of prophylactic antibacterial agents. Methods Application status of antibacterial agents was analyzed in 360 patients receiving type I incision operation in 2013 and 426 patients in 2014. ＇Results There were remarkable improvements of indication control, medication choice, usage and dosage, preoperative administration time in 2014, comparing with those in 2013. Rationality of indication control increased from 49.70% to 91.49%, rationality of medication choice increased from 70.06% to 100.00%. All the usage and dosage in 2014 were rational, and rationality of preoperative administration time increased from 62.28% to 98.94%. However, there was no statistically significant difference of application rate of prophylactic drugs between 2014 and 2013 （P〉0.05）, as 46.39% and 44.13%. They were all higher than standard in ministry of health （health development planning commission）. Although the long postoperative medication time had improvement, it still contained high irrationality rate. The difference of overall evaluation between the two years had statistical significance （P〈O.05）. Conclusion The general condition of prophylactic antibacterial agents in 2014 is much more rational than that in 2013, which shows normalized effect of rectification work in 2013 without repetition. While it is still necessary for further management and education strength applied in issues of medication time.