综合干预措施对颅脑清洁手术抗菌药物应用及手术部位感染的影响

The effect of comprehensive intervention measures on the application of antibiotics to craniocerebral clean surgery and the infection of surgical site

目的评价综合干预措施对颅脑清洁手术抗菌药物应用及手术部位感染的影响。方法将我院2015年9月~2017年12月颅脑清洁手术共210例患者作为干预前组,2018年1月~2019年8月颅脑清洁手术共222例患者为干预后组,比较干预前、后的抗菌药物管理指标变化及手术部位感染情况。结果干预后组的抗菌药物管理指标如品种合理选择比例、术前30~60min给药比例、术中合理追加比例、术后24h停药率均较干预前明显改善,差异均有统计学意义(P<0.05);干预后组的术后平均疗程缩短(P<0.05);干预后组术后手术部位感染发生率为2.25%,较干预前组(8.10%)明显下降,差异有统计学意义(P<0.05)。结论综合干预措施可以促进颅脑清洁手术预防抗菌药物的合理应用,能缩短抗菌药物使用时间,降低手术部位感染的发生率。

Objective To evaluate the effect of comprehensive intervention measures on the application of antibiotics to craniocerebral clean surgery and the infection of surgical site.Methods A total of 210 patients receiving craniocerebral clean surgery from September 2015 to December 2017 in our hospital were taken as the preintervention group,and 222 patients receiving craniocerebral clean surgery from January 2018 to August 2019 were taken as the post-intervention group.The changes of antibiotic management indexes and the infection of surgical site before and after the intervention were compared.Results The antibiotic management indexes of the post-intervention group such as the reasonable selection ratio of varieties,the administration ratio 30min to 60min before operation,the reasonable addition ratio during operation,and the withdrawal rate 24h after operation,were all significantly improved when compared with those before the intervention,and the differences were all statistically significant(P<0.05).The postoperative average course of treatment of the post-intervention group was shortened(P<0.05).The postoperative incidence of the infection of surgical site of the post-intervention group was 2.25%,significantly lower than that of the pre-intervention group(8.10%),with statistically significant difference(P<0.05).Conclusion Comprehensive intervention measures can promote rational use of preventive antibiotics in craniocerebral clean surgery,shorten time of the use of antibiotics and reduce the incidence of the infection of surgical site.