某院3种Ⅰ类切口手术围手术期患者预防用抗菌药物整治前后的相关因素分析

Analysis on Relative Factors in Prevention with Antibiotics before and after Treatment on 3 Kinds of Perioperative Patients with Ⅰ Incision Surgery

目的:分析某"三甲"医院2011年—2013年间3种Ⅰ类切口手术(甲状腺手术、乳腺手术、疝气修补术)围术期患者预防用抗菌药物整治前后的相关因素,供合理用药参考。方法:采用回顾性方法,对某"三甲"医院2011年—2013年间3种Ⅰ类切口手术患者489例,分析抗菌药物专项整治活动后抗菌药物使用时间、药品种类等指标,评价抗菌药物使用合理性。结果:经干预后3种Ⅰ类切口围手术期患者预防用药物的选择、用药时机、术后用药时间、联合用药等因素较专项整治活动前均明显得到改善;抗菌药物专项整治后的预防使用率由干预前的41.94%降至2.63%,经比较其差异有统计学意义(P<0.05)。结论:3种Ⅰ类切口围手术期患者预防用抗菌药物经专项整治,提高了围术期患者抗菌药物的合理用药水平,但仍存在较不规范现象,亟待采取相关措施加以干预。

Objective： To analyze on relative factors in prevention with antibiotics before and after treatment on 3kinds of perioperative patients with Ⅰ incision surgery（thyroid surgery, breast surgery and hernia repair） in a ＂TOP Grade＂ hospital during 2011 and 2013 and to provide a reference for the rational use of drugs. Methods： By retrospective survey of 498 patients of three types Ⅰ ware sampled from this hospital from 2011 to 2013,the evaluation indicators were analyzed statistically,such as the antibiotic using reasonable time,medication time,types of antibiotics and then evaluated whether these drugs were rationally used. Results： After the intervention,we found that in the three typesⅠincision surgery the choice of drugs,the medication time of antibiotics using,the medication course of patients post operation and the combination of drugs were greatly improved. The utilization ratio of antibiotics decreased from the highest41.94% to the lowest 2.63%. By comparing them the difference was statistically significant（P〈0.05）. Conclusion： The prophylactic usage of antibiotics for the three types I incision surgery has reached significant effects in hospital since the special rectification was conducted. It could improve the rational use of antibiotics in perioperative period obviously.However,there are still some non-standard phenomena,and some measures should be taken to intervene it.