3种Ⅰ类切口手术围手术期预防用抗菌药物干预对照研究  

Prophylactic use of antibiotics during perioperative period of three kind of type Ⅰ incision surgery:an interventional and case-control study

作　　者：杨珏[1] 亓志刚[1] 张秀红[1] 

机构地区：[1]南京医科大学附属无锡市人民医院药剂科,江苏无锡214023

出　　处：《中华医院感染学杂志》2013年第1期154-156,共3页Chinese Journal of Nosocomiology

基　　金：无锡市科技发展指导性计划项目(2011SCZ00N1136)

摘　　要：目的对比干预前、后医院甲状腺手术、乳腺手术、疝气修补术3种Ⅰ类切口手术预防用抗菌药物的合理性,考察干预措施的实施效果。方法选取医院3种Ⅰ类切口手术围手术期预防用抗菌药物干预对照研究2009年4-6月(干预前)及2010年11月-2011年1月(干预后)3种Ⅰ类切口手术的出院病历各110份,对比干预前、后预防用抗菌药物的合理性。结果经过干预,3种Ⅰ类切口围手术期预防用药在药物选择、预防用药时机、术后用药时间、联合用药方面较干预前均明显得到改善,抗菌药物的合理使用率由干预前的1例,占0.91%,提高到88例占80.0%;抗菌药物总费用占总住院费用比例由8.53%降至5.91%,抗菌药物总费用占药品总费用比例由32.21%降至25.64%。结论医院3种Ⅰ类切口手术围手术期预防用抗菌药物干预对照研究采取的干预措施有效、可行,可明显提高围术期抗菌药物的合理用药水平,降低药物费用,可为医院设计单病种临床路径及降低单病种费用提供依据。OBJECTIVE To compare the rationality of the prophylactic application of antibiotics in 3 kinds of type I incision operations including thyroid surgery, breast surgery, and repairing hernia surgery before and after the interventions. METHODS A total of 110 discharged cases which underwent 3 kinds of type Ⅰ incision operations were selected from the hospital during Apr 2009 to Jun 2009 （before the intervention） and Nov 2010 to Jan 2011 （after the intervention）. The rationality of the prophylactic application of antibiotics was compared before and after the intervention. RESULTS After the interventions, the choice of antibiotics, prophylactic medication time, postoperative medication time, and combined used of antibiotics of the three kinds of type Ⅰ incision surgeries were significantly improved as compared with those before the interventions. The rate of reasonable use of antibiotics increased from 0.91% （1 case） before the intervention to 80.0% （88 cases） after the intervention. The proportion of the antibiotic cost in total drug cost decreased from 32.21% to 25.64%, and the proportion of the antibiotics cost in the total hospitalization costs decreased from 8.53 % to 5.91%. CONCLUSION The intervention measures adopted by the hospital are effective and feasible, and can significantly improve the reasonable use of antibiotics and reduce the drug cost, which can also provide feasible and effective basis for designing clinical pathway and reducing the drug cost.

关 键 词：Ⅰ类切口手术 围手术期 抗菌药物 预防用药 

分 类 号：R978.1[医药卫生—药品]