山西省晋城市第二人民医院2014-2016年Ⅰ类切口围手术期抗菌药物预防使用情况分析

Analysis of prophylactic use of antibiotics during perioperative period of type 1 incision in the Second People - 2016 Hospital of Jincheng of Shanxi Province from 2014 to

目的分析山西省晋城市第二人民医院2014-2016年I类切口围手术期抗菌药物预防使用情况。方法选择2014年1月至2016年12月医院I类清洁手术病例为研究对象，其中2014年1月至2015年7月间201例为对照组，2015年8月至2016年12月间202例为观察组。对照组对抗菌药物应用一般干预，观察组则加强干预措施。比较两组用药开始时间、用药持续时间及抗菌药物应用品种。结果观察组术前0．5-1h用药比例显著高于对照组（89．11％比54．73％），术前1～24h（1．9％比24．4％）及术后用药比例（8．91％比20．9％）显著低于对照组，差异均有统计学意义（#=59．027、44．251、11．420，均P〈0．05）。观察组用药持续时间≤1d的比例（89．6％比62．7％）显著高于对照组，1〈T≤2d（9．9％此22．4％）及〉2d（O．5％比14．9％）者显著低于对照组，差异均有统计学意义（x2=40．226、11．613、29．546，均P〈0．05）。观察组应用一代头孢（79．7％比48．2％）及二代头孢（12．8％比5．4％）的比例显著高于对照组，应用三代头孢、氟喹诺酮类抗菌药的比例显著低于对照组，差异均有统计学意义（x2=43．246、6．614、47．960、8．203，均P〈0．05）。结论加强干预措施后，该院I类切口围手术期抗菌药物预防使用时间、预防使用疗程、药物品种选择更加合理。

Objective To analyze the use of antibiotics in perioperative period of type 1 incision in our hospital from 2014 to 2016. Methods The type 1 incision of clean operation cases in our hospital from January 2014 to December 2016 were selected as the research subjects. Among them, 201 cases were assigned as the control group from January 2014 to July 2015 ,while 202 cases were set as observation group from August 2015 to December 2016. General intervention in the using status of antibiotics was adopted for the controls, meanwhile, intensive intervention was given to observation groups. At the same time, the types of antibiotics, the beginning time and duration of antibiotics use were compared between the two groups. Results Before operation, the antibiotics use proportion of 0.5 - 1 h in the observation group was significantly higher than that in the control group （89.11% vs. 54.73% ）. The antibiotics use proportion of preoperative 1 - 24h （ 1.9% vs. 24.4% ） and postoperative drug use ratio （ 8.91% vs. 20.9% ） were significantly lower than those in the controt group, the differences were statistically significant （ x2 = 59. 027, 44. 251,11. 420, all P 〈 0.05）. The ratio of treatment duration ≤1d in the observation group （ 89.6% vs. 62.7 % ） was Significantly higher than the control group,the proportions of 1 〈 T≤2d（9.9% vs. 22.4% ） and 〉 2d（0.5% vs. 14.9% ） in the observation group were significantly lower than those in the control group, the differences were statistically significant （ x2 = 40.226,11. 613,29.546, all P 〈 0.05 ）. In the observation group, the ratios of the first generation cephalosporin （79.7% vs. 48.2% ） and the second generation cephalosporin （ 12.8% vs. 5.4% ） were significantly higher than those of the control group （ all P 〈 0.05 ）. The proportions of the third generation cephalosporin and fluoroquinolones were significantly lower than those of the control group, the differences were statistically significant （X2 =43.246,6. 614,47.960,8.203,all P〈0.05）. Conclusion After the intensive intervention,the duration of prophylaxis and drug selection in the perioperative period of type 1 incision is more reasonable.