规范围手术期抗菌药物合理应用的研究  

Reasonable use of antibiotics during perioperative period

作　　者：杨艳[1] 张静[1] 钟晓祝[1] 尹雪如[1] 谭细兰[1] 余楠[2] 

机构地区：[1] 南方医科大学珠江医院感染管理科 [2]南方医科大学珠江医院 检验医学部,广东广州510280

出　　处：《中华医院感染学杂志》2014年第18期4455-4456,4462,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学青年科学基金资助项目(81101320)

摘　　要：目的通过对围手术期抗菌药物合理应用的管理与监测,提高抗菌药物合理应用率,降低手术部位感染率。方法以某三甲医院神经外科颅内Ⅰ类切口手术为研究对象,设对照组(干预前):2011年神经外科颅内手术Ⅰ类切口病例,共479例;干预组:2012年神经外科颅内手术Ⅰ类切口病例,共406例,比较干预前、后合理用药率及手术部位感染率。结果干预后术前30min^2h抗菌药物使用合理率由82.25%升至99.01%,差异有统计学意义(P<0.001);预防用药品种合理率由72.08%升至92.79%,差异有统计学意义(P<0.001);术中追加药物合理率由50.56%升至75.52%,差异有统计学意义(P<0.001);中位用药时间由3d下降至2d,差异有统计学意义(P<0.001);手术部位感染率从14.61%下降至10.10%,差异有统计学意义(P<0.05)。结论通过对围手术期抗菌药物合理应用的目标性管理与监测,提高抗菌药物合理应用,可有效降低手术部位的感染率。OBJECTIVE To conduct and monitor the reasonable use of antibiotics during the perioperative period so as to raise the rate of reasonable medication and reduce the incidence of surgical site infections .METHODS T he pa-tients who underwent the type Ⅰ intracranial incision surgery in neurosurgery department of a three A hospital were recruited as the study objects ,including 479 cases who underwent the type Ⅰ intracranial incision surgery in neurosurgery department in 2011 and were assigned as the control group （before intervention） and 406 cases who underwent the type Ⅰ intracranial incision surgery in neurosurgery department in 2012 and were set as the inter-vention group ,the rate of reasonable medication and the incidence of surgical site infections were observed and compared between before and after the intervention .RESULTS At 30 min-2 hours after the intervention ,the rate of reasonable use of antibiotics significantly increased from 82 .25% to 99 .01% （P〈0 .001）;the rate of reasonable use of prophylactic antibiotics significantly increased from 72 .08% to 92 .79% （P〈0 .001）;the rate of reasonable use of intraoperative additional drugs significantly increased from 50 .56% to 75 .52% （P〈 0 .001）;the median medication duration significantly decreased from 3 days to 2 days（P〈0 .001）;the incidence of surgical site infec-tions significantly decreased from 14 .61% to 10 .10% （P〈0 .05） .CONCLUSION It is an effective way to conduct the targeted management and monitoring of reasonable use of antibiotics during the perioperative period and im-prove the reasonable use of antibiotics so as to reduce the incidence of surgical site infections .

关 键 词：围手术期 抗菌药物 合理使用 手术部位感染 

分 类 号：R978.1[医药卫生—药品]