骨科Ⅰ类切口手术抗菌药物预防使用干预效果研究  

Study on the use of prophylactic antibiotics in orthopedics type Ⅰ incision

作　　者：卓霞[1] 阚燕[1] 闽鹏[1] 

机构地区：[1]成都市第一人民医院,成都610016

出　　处：《中国抗生素杂志》2013年第10期799-800,I0001,I0002,共4页Chinese Journal of Antibiotics

摘　　要：目的比较国家“限抗令”政策下，我院骨科在采取抗菌药物干预措施后，I类切口手术预防性抗菌药物使用状况的变化。方法回顾性分析本院骨科2010年7—2012月7月收治的的2288例I类切口手术患者病历，并按照医院进行抗菌药专项整治活动时点将病例分为两组：2010．7—2011．7为治理前组（A组），2011．8—2012．7为治理后组（B组）。比较两组预防性抗菌药物使用率、抗菌药物品种、用药时机、用药疗程及联合用药情况。结果共收集合格病例2188份，其中A组1135份，B组1053份。在A和B组中有人工植入物的手术比例分别为46．3％和61．4％。A组和B组I类切口手术预防性抗菌药物使用率分别为89．8％和65．0％，其中无植入物手术的使用率分别为81．O％和15．5％。有植入物手术中，A组与B组用药品种合理率分别为48．4％和79．5％，无植入物手术中，A组与B组品种合理率分别为28．7％和46．2％。术前0．5—2h内预防用药比例在A和B组分别75％和80％，A和B组平均用药时间分别为6．8±2．6d和2．6±1．3d；A和B组联合用药率分别为11．2％和1_3％。统计学分析，A和B组相比，I类切口手术预防性抗菌药物使用率、用药品种合理率、用药时机、用药疗程、联合用药比例5方面都存在统计学差异‘P〈0．05）。结论我院在抗菌药物整治后，骨科I类切口手术的预防性用药有一定改善，但因近1年来有人工植入物的手术比例大，抗菌药的使用率和疗程与国家标准存在差距，有待进一步改进。To evaluate prophylactic use of antibiotics in orthopedics type I incision in my hospital under the guidance of national principles of antibiotic management. Methods A retrospective analysis was employed to learn 2188 cases admitted to orthopaedic surgery with type I incision in my hospital from July in 2010 to July in 2012. The cases were divided into pre - treatment group （group A） and improving group （group B） evenly, according to the time of national policy activities. Some index were compared between two groups, including the rate of prophylactic antibiotics use, varieties of antimicrobial drugs, medication timing, duration of drug treatment and combined treatment. Results 1135 cases of group A and 1053 cases of group B were analyzed, and the proportion of artificial implant surgery was 46.3% in group A and 61.4% in group B. 89.8% and 65.0% cases in group A and group B were administered with prophylactic antibiotics, respectively. The proportions of rational drug use were 48.4% in group A and 79.5% in group B among the patients with artificial implant surgery, and 28.7% and 46.2% among the patients without artificial implant surgery. Reasonable rate of medication timing （antibiotics use within 0.5~2h before operation） in group A and group B were 75% and 80%, respectively. The average treatment time were （6.8＋2.6）d and （2.6＋1.3）d, and the incidence of antibiotics in combination were 11.2% and 1.3% in group A and B, respectively. There was significant difference in many indexes such as prophylactic antibiotics use, drug varieties, duration of drug treatment, the proportion of combination therapy （P〈0.05）. Conclusion The condition of prophylactic use of antibiotics in orthopedics type I incision were improved after antibiotic management, though a large proportion of the artificial implant surgery existed. It needs to take more efforts to reducing the proportion of antimicrobial drug usage and shorting treatment time in case of national standard.

关 键 词：骨科 I类切口 预防性用药 抗菌药物 

分 类 号：R978.1[医药卫生—药品]