Ⅰ类切口围手术期预防性使用抗菌药物干预分析  

Interventions to antibiotic prophylaxis during perioperative period of typeⅠincision surgery

作　　者：仲华[1] 刘鹰[1] 吴芳[1] 王玮[1] 李彦[1] 

机构地区：[1]武警总医院药剂科,北京100039

出　　处：《中华医院感染学杂志》2015年第13期2973-2975,共3页Chinese Journal of Nosocomiology

基　　金：武警总部卫生部科研基金资助项目(WZ2011019)

摘　　要：目的研究经全国抗菌药物临床应用专项整治以及等级医院评审的药学干预后乳腺、甲状腺手术、腹股沟疝修补术3种Ⅰ类切口手术围术期预防性使用抗菌药物的合理性。方法随机选取2010年7-12月和2013年7-12月3种手术Ⅰ类切口病历各100份,对围手术期预防性抗菌药物的使用率、选用药物品种、给药时机、用药持续时间及伤口愈合等进行对比。结果 3种Ⅰ类切口手术抗菌药物使用率由干预前的99.3%降至干预后12.0%,乳腺手术、甲状腺手术、疝气手术的抗菌药物使用率分别由干预前的98.0%、100.0%、100.0%,降至干预后的16.0%、11.0%、9.0%;合理应用率高达91.0%;整改后的300例患者无切口感染,并且切口甲级愈合占98.3%;Ⅰ类切口手术预防用抗菌药物的用药品种,由2010年的三代头孢菌素使用率62.3%改进为2013年的一代头孢菌素的使用率88.9%,并且杜绝了无依据的更换药品。结论药学干预与行政干预显著降低了Ⅰ类切口手术抗菌药物预防性使用率,提高了抗菌药物使用的合理率。OBJECTIVE To study the rationality of antibiotic prophylaxis during the perioperative period of three type I incision surgeries including the breast surgery ,thyroid surgery ,and inguinal hernia repair after the special rectification of national clinical use of antibiotics and pharmaceutical intervention of grade hospital accreditation . METHODS Totally 100 medical records of the patients who underwent the type Ⅰ incision surgeries from Jul 2010 to Dec 2010 and 100 medical records of the patients who underwent the type Ⅰ incision surgeries from Jul 2013 to Dec 2013 were randomly enrolled in the study ,then the rates of antibiotic prophylaxis during the perioperative pe‐riod ,types of used antibiotics ,drug administration timing ,medication duration ,and wound healing were observed and compared .RESULTS The utilization rate of antibiotics of the three type Ⅰ incision surgeries decreased from 99 .3% before the interventions to 12 .0% after the interventions .The utilization rate of antibiotics of the breast surgery dropped from 98 .0% before the interventions to 16 .0% after the interventions ,the thyroid surgery from 100 .0% to 11 .0% ,the inguinal hernia repair from 100 .0% to 9 .0% ;the rate of reasonable use of antibiotics reached up to 91 .0% .The incision infections did not occurred in 300 patients after the rectification ,and the pa‐tients with grade A incision healing accounted for 98 .3% .As for the types of prophylactic antibiotics for the typeⅠ incision surgeries ,the utilization rate of the third generation cephalosporins was improved from 62 .3% in 2010 to 88 .9% of the first generation of cephalosporins in 2013 ,and the blind replacement of drugs was put into an end .CONCLUSION The pharmaceutical intervention and administrative intervention contribute to the significant reduction of the utilization rate of antibiotics prophylaxis for the type Ⅰ incision surgeries and to the improvement of rationality of use of antibiotics .

关 键 词：Ⅰ类手术切口 围手术期 抗菌药物 

分 类 号：R978.1[医药卫生—药品]