心血管介入手术预防性使用抗菌药物的干预研究  

Study on interventions to antibiotics prophylaxis of patients undergoing cardiovascular interventional surgery

作　　者：赵莹[1] 李玉英[1] 桑博默[1] 关永冠[1] 陆青[1] 

机构地区：[1]广西中医药大学第一附属医院医院感染管理科,广西南宁530023

出　　处：《中华医院感染学杂志》2015年第11期2456-2458,共3页Chinese Journal of Nosocomiology

基　　金：广西壮族自治区卫生厅科研基金资助项目(Z2012175)

摘　　要：目的通过采取强化干预措施规范心血管介入手术(CI)预防性使用抗菌药物的管理,达到促进抗菌药物临床合理应用的目的。方法采用计算机网络信息系统收集2012年1-12月和2014年1-12月施行CI的患者相关资料,应用SPSS16.0进行数据统计分析,研究采取强化干预措施前后围手术期预防性抗菌药物使用与术后感染发生及住院时间的关系,评价干预效果。结果共调查1 078例CI手术患者,干预前534例、干预后544例,住院时间(12.5±6.6)d,其中行冠状动脉造影术792例占73.5%,经皮冠状动脉介入术286例占26.5%;干预前64例预防性使用抗菌药物,均于术后给药,单用占93.8%,术后用药时间≥3d的占50.0%,最长达12d,用药种类多达5类8种,以头孢菌素类为主,占50.0%,干预后所有手术患者均未预防性使用抗菌药物;实施强化干预措施前、后,平均住院时间分别为14.9、10.2d,预防性抗菌药物使用率为12.0%、0(P=0.000),所有手术患者均无感染发生。结论采取强化干预措施是规范抗菌药物预防性使用的强有力手段,可显著降低CI预防性抗菌药物使用率,缩短患者住院时间,减轻患者经济负担。OBJECTIVE To take the intensified interventions to standardize the prophylactic use of antimicrobial agents of the patients undergoing cardiovascular interventional surgery so as to reasonably use antimicrobial agents .METHODS The related data of the patients who underwent the cardiovascular interventional surgery from Jan to Dec ,2012 and from Jan to Dec ,2014 were collected by using the computer‐network information system , then the statistical analysis of the data was performed with the use of SPSS 16 .0 software ,the relationship between the perioperative antibiotics prophylaxis and the incidence of postoperative infections and length of hospital stay was observed before and after the intensified interventions were taken ,and the intervention effects were evaluated . RESULTS A total of 1 078 patients who underwent the cardiovascular interventional surgery were investigated ,of whom 534 were investigated before the intervention and 544 were investigated after the intervention ;the length of hospital stay was （12 .5 ± 6 .6）days ;there were 792 （73 .5% ） patients who underwent the coronary angiography and 286 （26 .5% ） patients who underwent the percutaneous coronary intervention .Totally 64 patients were given antibiotics prophylaxis before the intervention and were administrated after the surgery ,of whom 93 .8% were given one‐drug therapy ,50 .0% were given the postoperative medication for no less than 3 days ,the longest up to 12 days ,5 categories of antibiotics covering 8 types were used ,and the cephalosporins were dominant ,accounting for 50 .0% .None of the patients was treated with antibiotics prophylaxis after the intervention .The average length of hospital stay was 14 .9 days before the interventions were taken ,10 .2 days after the interventions were taken;the rate of prophylactic use of antibiotics was 12 .0% before the intervention ,0 after the intervention （P=0 .000 ） , and no patient had the infections .CONCLUSIONS It is a powerful mean to take the intensified interventions

关 键 词：心血管介入手术 抗菌药物 干预 

分 类 号：R978.1[医药卫生—药品]