预防使用抗菌药物对甲状腺手术切口感染的影响  

Influence of antimicrobial prophylaxis in surgical site infection following thyroid surgery

作　　者：陈玉华[1] 刘珍如[1] 冯丽[1] 吴安华[1] 

机构地区：[1]中南大学湘雅医院,湖南长沙410008

出　　处：《中国感染控制杂志》2014年第5期263-265,270,共4页Chinese Journal of Infection Control

基　　金：卫生部行业基金(201002021);湖南省科技厅项目(2012SK3200)

摘　　要：目的探讨围手术期预防使用抗菌药物对甲状腺手术切口感染的影响。方法在抗菌药物使用整顿前后,医院感染管理专职人员对某三级甲等医院甲状腺手术患者抗菌药物使用和手术切口愈合情况及医院感染情况进行调查并比较。结果 2011年4—8月(整顿前)甲状腺手术抗菌药物使用率为99.53%(211/212),2012年4—8月(整顿后)甲状腺手术抗菌药物使用率为10.89%(22/202),整顿前后抗菌药物使用率比较,差异有统计学意义(χ2=334.23,P<0.001)。2011年4—8月发生医院感染8例,医院感染率为3.77%(8/212),其中切口感染3例(1.42%);2012年4—8月发生医院感染6例,医院感染率为2.97%(6/202),其中切口感染2例(0.99%)。两组病例医院感染率及切口感染率比较,差异均无统计学意义(P>0.05)。结论该院的甲状腺手术围手术期用药经规范后,减少了围手术期抗菌药物的使用,但并未导致甲状腺手术术后切口感染和医院感染率的增加。Objective To evaluate the influence of perioperative antimicrobial prophylaxis in surgical site infection （SSI）following thyroid surgery.Methods Application of antimicrobial agents,healing status of surgical wound, and occurrence of healthcare-associated infection （HAI）in thyroid surgery patients before and after performing anti-microbial stewardship program were surveyed and compared.Results Antimicrobial use prevalence was 99.53%（211/212）in 2011 （from April to August,before stewardship intervention）and 10.89% （22/202）in 2012 （from April to August,after stewardship intervention）,difference was statistically different（χ2=334.23,P〈0.001 ）. HAI rate was 3.77% （8/212）in 2011 and 2.97%（6/202）in 2012,and SSI rate was 1.42% （3/212）and 0.99%（2/202）respectively.There was no statistical difference in HAI and SSI rate between two groups（P〉0.05）.Con-clusion Rational perioperative antimicrobial prophylaxis enhanced significantly after antimicrobial stewardship pro-gram was performed,the reducing of perioperative antimicrobial use does not result in the increase of SSI and HAI rate.

关 键 词：甲状腺手术 切口感染 手术部位感染 医院感染 围手术期 抗菌药物 合理用药 

分 类 号：R969.3[医药卫生—药理学]