妇科围手术期抗菌药物使用干预成效研究

Effectiveness of antimicrobial drugs intervention in perioperative period of gynecology

目的分析总结妇科围手术期使用抗菌药物存在问题及对手术部位感染的影响,为临床合理使用抗菌药物提供参考依据。方法采用前瞻性调查方法将2011年1-12月妇科经腹全子宫切除手术病例设为对照组(干预前)345例,2012年1-12月妇科经腹全子宫切除手术病例设为观察组(干预后)308例;比较两组之间的手术部位感染率、围手术期药物选择是否合理等。结果干预前手术例数为345例,感染81例,感染率为23.48%;干预后感染率为18.83%,干预后与干预前相比,差异无统计学意义;干预后药物选择合理率高于干预前,干预后术后用药时间≤48h率高于干预前,干预后联合用药合理率高于干预前,差异均有统计学意义(P<0.05)。结论采取综合干预措施控制围手术期抗菌药物用药后,抗菌药物使用基本符合规范,手术部位感染发生率有下降趋势;综合干预能使围手术期抗菌药物使用起到事半功倍的效果。

OBJECTIVE To explore the problems of the antimicrobial drugs used in gynecological perioperative period and their effects on the infection of surgical sites,so as to provide references for rational use of antibiotics in clinic.METHODS Using aprospective survey method,345 cases of gynecologic abdominal hysterectomy conducted from Jan.2011 to Dec.2011 were set as control group（before intervention）,and 308 cases of gynecologic abdominal hysterectomy conducted from Jan.2012 to Dec.2012 were set as control group（after intervention）.The infection rates of surgical sites and situation of reasonable perioperative drug usage between the two groups were compared.RESULTS There were 81 cases of patients occurred infection before intervention,accounting for23.48%,and 18.83% of patients occurred infection after intervention.The rational rate of drug selection after intervention was higher than that before intervention,the rate of drug usage time≤48hafter intervention was higher than that before intervention,the rational rate of drug combination after intervention was higher than that before intervention,and there were significant differences（P〈0.05）.CONCLUSION After a comprehensive intervention to control the use of antimicrobial drugs in gynecological perioperative period,the use of antimicrobial drugs is basically in accordance with the norms,and the infection rate of surgery site has a downward trend.Comprehensive interventions can double the effect of antimicrobial drugs in gynecological perioperative period.