卵巢手术患者规范应用抗菌药物对医疗评价指标的影响  

Effects of standardized application of antibiotics on medical quality evaluation indicators in patients with ovarian surgery

作　　者：崔艳[1] 杨晓葵[2] 游川[1] 潘丽娟[1] 

机构地区：[1]首都医科大学附属北京妇产医院疾病预防控制及医院感染管理科,北京100026 [2]首都医科大学附属北京妇产医院疾病预防控制及医院生殖医学科,北京100026

出　　处：《中华医院感染学杂志》2015年第3期586-588,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81170542)

摘　　要：目的了解医院卵巢手术患者规范使用抗菌药物对其医疗评价指标的影响。方法回顾性分析2011年规范使用抗菌药物前后卵巢手术住院患者各项医疗评价指标的变化,利用SPSS11.0统计软件对数据进行统计分析。结果住院死亡类、重返类、医院感染类、手术并发症类指标整治前后未发生变化;卵巢手术患者整治前抗菌药物费用、人均药品费、人均使用抗菌药物天数、药占比,分别为1 247.28元、2 375.94元、9d、0.52,整治后分别为308.27元、1380.10元、1.38d、0.22,差异有统计学意义(P<0.05);整治前单联用药、术前2h内应用抗菌药物、手术后持续用药时间>48h的患者,分别占37.04%、29.63%、95.83%,整治后分别占100.00%、66.67%、44.44%,差异有统计学意义(P<0.05);整治前手术持续时间<2h的术后抗菌药物使用率为100.00%,整治后下降至58.14,差异有统计学意义(P<0.05);NNIS分级为0级的患者经t检验其整治前后发生变化的指标为平均住院日、人均住院费、人均药品费用、人均抗菌药物费用、人均手术后住院日,整治后较整治前均有明显下降。结论抗菌药物的规范应用对医院的作用明显,对清洁切口手术抗菌药物的应用起到了很好的规范作用,对降低费用、缩短住院日起到了明显的作用。OBJECTIVE To understand the effects of standardized application of antibiotics on the medical quality evaluation indicators in patients with ovarian surgery. METHODS The medical quality evaluation indicator changes before and after using antibiotics regularly in patients with ovarian surgery in 2011 were analyzed retrospectively. SPSS 11.0 was adopted for a statistical analysis. RESULTS The index of patients who died in hospital, returned back, infected in hospital, combined with operative complications did not change before and after using antibiotics regularly. The antibiotic expense, medicine expense per capita, the duration and proportion of using antibiotics per capita were 1 247.28 yuan, 9, 375.94 yuan, 9 d and 0.52 respectively before rational use of antibiotics. The index decreased to 308.27 yuan, 1 380.10 yuan, 1.38 d and 0.22 after the adjustment. The difference was significant（P d0.05）. Before the adjustment, patients using single therapy, adopting antibiotics in two hours after the surgery and keeping using the drugs more than 48 hours accounted for 37. 04%, 29. 63%, 95.83% respectively. The index was 100. 00%, 66. 67%, 44. 44M after the adjustment. The difference was significant （P% 0. 05）. Through t-test, the average length of the stay, the hospitalization expense per capita, the drug expense per capita, the antibiotics expense per capita and the length of stay after surgery per capita has changed in patients with 0-level according to NNIS before and after adopting the adjustment. The index decreased obviously after the adjustment. CONCLUSION The standardized antibiotic use has remarkable effect on medical quality of the hospitals. It can standardize the application of antibiotics in cleaning incision and can obviously decrease expenses and shorten the length of hospital stay.

关 键 词：抗菌药物 卵巢手术 医疗质量 

分 类 号：R978.1[医药卫生—药品]