预防Ⅰ类切口感染用药的干预对比研究  

Interventional comparative study of prophylactic application of antimicrobial drugs in typeⅠincision

作　　者：张士勇[1] 叶云[1] 程军[1] 季明娟[1] 王刚斌[1] 王儒强[1] 

机构地区：[1]安徽省蚌埠市第三人民医院药学部,233000

出　　处：《淮海医药》2013年第2期95-97,共3页Journal of Huaihai Medicine

基　　金：2012年蚌埠市医疗卫生类科技计划项目(20120309)

摘　　要：目的调查我院实施综合干预措施前后围手术期患者抗菌药物的应用情况,评价综合干预方法的可行性及有效性,探索行之有效的干预模式。方法将我院2011年1～6月295例I类切口手术出院患者设为非干预组,2012年1～6月369例Ⅰ类切口手术出院患者设为干预组,对比2组I类切口手术预防用抗菌药的合理性,对抗菌药物应用情况、应用时间及费用情况等进行对比分析。结果干预后,Ⅰ类切口手术预防用药在抗菌药物使用率、药物选择、首次给药时机、预防用药疗程等方面的合理性显著提高;抗菌药物使用率从干预前的100%下降至干预后的44.17%,联合用药率干预前为9.15%干预后下降至0。在药物的选择上,头孢唑林出现的频次明显升高。在首次给药时机上,术前0.5～2 h给药例数所占比例显著增多,平均抗菌药物费用明显下降,抗菌药物不合理应用情况得到明显改善。结论实施的干预措施对促进安全、有效、合理地使用抗菌药物起到了积极作用,为推进抗菌药物专项整治、降低医疗费用,提供了一种切实可行的干预模式。Objective To investigate the application of antibacterial drugs before and after the implementation of comprehensive intervention measures on perioperative patients,and evaluate feasible and effective intervention methods.Methods 295 cases of type Ⅰ incision surgery patients in our hospital between January to June,2011 were included in a non-intervention group and another 369 cases between January to June,2012 in an intervention group.The two groups were compared in terms of the rationality of application of antimicrobial agents,the antibacterial drugs utilization rate,choice,first time to use medicine,preventive medicine treatment and cost.Results After the intervention,the rationality of prophylactic application of antimicrobial drugs in type Ⅰ incision was improved significantly in respects of drug selection,initial medication time,preventive medication treatment and utilization ratio of antimicrobial drugs.Prophylactic application rate of antimicrobials decreased from 100% before intervention to 44.17% after intervention;the rate of drugs combination decreased from 9.15% before intervention to 0 after intervention.After the intervention,the frequency of cefazolin increased significantly and the proportion of preventive medication of 0.5~2h before operation gradually increased.Average antibacterial cost decreased significantly,and irrational use of antibiotics was improved obviously.Conclusion The implementation of the intervention measures plays a positive role in promoting the safe,effective and rational use of antibiotics and reducing the medical costs.It also provides a feasible intervention mode for the antimicrobial agents special regulation.

关 键 词：Ⅰ类切口手术 围手术期 抗菌药物 干预模式 合理用药 

分 类 号：R613[医药卫生—外科学] R969.3[医药卫生—临床医学]