冠状动脉旁路移植术预防用药干预效果分析  

Effect of prophylactic antibiotics in coronary artery bypass grafting

作　　者：李夏明[1] 陈方 刘昆 李京明[1] 毕蓉蓉[1] 束冬兰[1] 

机构地区：[1]首都医科大学附属北京安贞医院医院感染管理办公室 [2]院长办公室 [3]医务处,北京100029

出　　处：《中华医院感染学杂志》2011年第16期3379-3381,共3页Chinese Journal of Nosocomiology

摘　　要：目的讨论冠状动脉旁路移植术(CABG)预防用药干预效果。方法应用统计学方法,对预防用药干预后3个月和干预前1年同期CABG手术病例进行对比分析。结果干预组较对照组平均住院日缩短1.38 d,死亡率下降1.34%;干预组手术采用头孢呋辛预防用药占72.15%,单联预防用药病例医院感染发病率低于对照组,差异有统计学意义(P<0.05);干预组手术切口感染率降低了0.44%,平均住院日缩短17.34 d;通过干预,手术当日预防用药级别降低,联合用药减少,杜绝了≥3种预防用药,手术当日预防用药类别趋于合理。结论医院对心脏手术选择二代头孢菌素的干预措施是有效的;应当把监测数据反馈临床,使外科医师建立信心,提高合理用药的依从性,进一步巩固干预成果;对于心脏外科手术预防用药的干预仍需不断探索,深入进行。OBJECTIVE To analyze the effectiveness of preventive antibiotics using in coronary artery bypass grafting（CABG）.METHODS The CABG patients（study group） after the regulation of preventive antibiotics within 3 months to whom（control group） undergone CABG in three months one year ago were analysed.RESULTS Compared to control group,the CABG patients in study group raised 8.24% with average hospitalization days and mortality declined by 1.38d and 1.34%,respectively.72.15% of operations in study group took cefuroxime for preventive purpose.Difference of hospital infection was statistically significant between the patients of taking single kind preventive antibiotics in study group and control group.The rate of surgical wound infection declined 0.44%,average hospitalization day of patients of surgical wound infection declined 17.34 d apparently.The CABG needn′t use antibiotics in 3 kinds or above.It could decrease the combined drug using and make preventive antibiotics using more conscious.CONCLUSIONS Using cefuroxime for preventive purpose in CABG is effective.CABG is a complicated operation containing many risk factors,the clinics prefer higher grade and combined antibiotics with long term based on their own experience but not on the evidence-based medicine.It will give the date to the clinics to strength their confidence and promote the compliance of rational use of antibiotics.

关 键 词：冠状动脉旁路移植术 预防用药 干预 

分 类 号：R181.32[医药卫生—流行病学]