骨科Ⅰ类切口手术预防性使用抗菌药物调查分析  

Investigation and analysis of prophylactic use of antibiotics for type Ⅰ incision orthopedic surgery

作　　者：王芳[1] 包蕾[1] 曹亚丽[1] 

机构地区：[1]南通市第三人民医院感染管理科,江苏南通226006

出　　处：《中华医院感染学杂志》2012年第21期4867-4869,共3页Chinese Journal of Nosocomiology

摘　　要：目的调查骨科3年Ⅰ类切口手术围手术期预防使用抗菌药物情况,了解骨科执行抗菌药物干预措施,为进一步规范骨科抗菌药物使用提供理论依据。方法回顾性调查2010年8月、2011年8月、2012年4月骨科Ⅰ类切口手术232例出院患者抗菌药物使用及切口感染率。结果 2010、2011、2012年抗菌药物预防使用率分别为100.0%、69.7%、70.6%,品种选择合理率分别为15.5%、65.6%、63.3%,用药时机合理率分别为82.8%、88.7%、93.3%,使用疗程合理率分别为1.7%、8.1%、20.0%,切口感染率分别为1.7%、1.1%、0。结论通过加强对围手术期预防用药的管理,在减少预防用药的前提下,骨科3年切口感染率呈下降趋势,但在抗菌药物预防使用率、规范选用抗菌药物、预防用药时间等方面仍未达到卫生部要求,需进一步加强监管和培训力度,促进抗菌药物合理使用。OBJECTIVE To investigate the antibiotics prophylaxis during the perioperative period of the type Ⅰ incision orthopedic surgery in the recent three years,to understand the interventions to use of antibiotics so as to provide theoretical basis for further standardizing the use of antibiotics.METHODS Totally 232 patients with incision infections,who underwent the type Ⅰincision orthopedic surgery in Apr 2012,Aug 2011,and Aug 2010 and discharged from the hospital,were selected as the study objects,the use of antibiotics and the incidence of incision infections were observed.RESULTS The utilization rates of the antibiotics prophylaxis in 2010,2011,and 2012 were 100.0%,69.7%,and 70.6%,respectively,the reasonable rates of the selection of antibiotics were 15.5%,65.6%,and 63.3%,respectively.The rational rates of the medication timing were 82.8%,88.7%,and 93.3%,respectively,the reasonable rate of the treatment course were 1.7%,8.1% and 20.0%,respectively,and the incidence rates of the incision infections were 1.7%,1.1%,and 0%,respectively.CONCLUSION Under the condition of strengthening the management of prophylactic use of antibiotics during perioperative period and shortening the antibiotics prophylaxis,the incidence rate of the incision infections keeps a downward tendency in the recent three years.The utilization rate of antibiotic,the standard use of antibiotics and antibiotics prophylaxis timing remain not meeting the standards of the Ministry of Health,thus it is necessary to further strengthen the supervision and training so as to prompt the reasonable use of antibiotics.

关 键 词：Ⅰ类切手术 围手术期 抗菌药物 

分 类 号：R978.1[医药卫生—药品]