清洁切口手术围手术期抗菌药物预防性应用的干预与成效  

Intervention and effect of prophylactic use of antibiotics during perioperative period of cleaning incision surgery

作　　者：覃金爱[1] 黄小红[1] 黄娟[1] 黄春芳[1] 张云 

机构地区：[1]广西医科大学第一附属医院医院感染管理科,广西南宁530021

出　　处：《中华医院感染学杂志》2011年第12期2562-2564,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨政策干预措施在规范围手术期抗菌药物预防性应用(PAP)的作用。方法以《抗菌药物临床应用指导原则》和《围手术期预防应用抗菌药物指南》的条款作为评价指标,对清洁切口手术围手术期抗菌药物预防性应用情况进行检查评估,对违反指南的病例所在科室进行点名批评、责令整改,严重者给予一定的经济处罚等,汇总2010年4-10月抽查的手术病例预防用药情况,统计围手术期抗菌药物预防性应用选药合理和疗程变化。结果 2010年4-10月抽查清洁切口手术病例810例,涉及甲状腺、乳腺、疝气、鞘膜积液、眼科、肿瘤介入治疗、大血管手术(含支架置入)、疤痕修复、开颅肿瘤切除、腹腔肿瘤切除、脾切除和骨科手术等,清洁切口手术病例围手术期抗菌药物预防性应用的选择合理率逐步增加,从督查初期4月份的58.0%上升至10月份的86.5%;预防用药的疗程也逐渐缩短,疗程≤24 h的比例从4月份的23.6%上升至10月份的50.0%;疗程≥3 d的比例从63.4%下降至23.2%;预防用药从督查开始的手术病例预防使用抗菌药物比例达100.0%下降至未用药的比例12.2%。结论干预措施能使抗菌药物预防性应用品种选择合理率增加,预防的疗程缩短,促进合理规范的围手术期抗菌药物预防。OBJECTIVE To investigate the effect of interventions in perioperative antimicrobial prophylaxis（PAP）.METHODS PAP was supervised according to the guidelines of perioperative antimicrobial prophylaxis.Data was collected from different departments and analyzed by the compliance to guidelines in kind of antimicrobial agents used before operation and duration of prophylaxis during Apr and Oct 2010.RESULTS The rate compliance to guidelines of used antimicrobial agents was increased from 58.0% to 86.5%.The rate of prophylactic duration within 24 hours was increased from 23.6% to 50.0%,conversely,the rate of duration more than 3 days was decreased from 63.4% to 23.2%.The rate of cases without antimicrobial prophylaxis was increased from 0 to 12.2%.CONCLUSION Interventions could promote the compliance to guidelines in antimicrobial prophylaxis.

关 键 词：围手术期 抗菌药物预防 干预 

分 类 号：R978.1[医药卫生—药品]