四肢闭合性骨折Ⅰ类切口手术患者合理应用抗菌药物调查  

Investigation of rational use of antibiotics in patients with closed fracture of extremities with type Ⅰ incision

作　　者：陈锋[1] 马刚[2] 肖识愚 张莉[2] 栾仕波 杨蓉[4] 

机构地区：[1]攀枝花市攀钢集团总医院药剂科,四川攀枝花617063 [2]攀枝花市攀钢集团总医院骨科,四川攀枝花617063 [3]攀枝花市攀钢集团总医院信息中心,四川攀枝花617063 [4]攀枝花市攀钢集团总医院检验科,四川攀枝花617063

出　　处：《中华医院感染学杂志》2017年第15期3525-3528,共4页Chinese Journal of Nosocomiology

摘　　要：目的调查"抗菌药物应用专项整治活动"前四肢闭合性骨折Ⅰ类切口抗菌药物应用情况,并与专项整治活动后进行对比分析,对四肢闭合性骨折Ⅰ类切口抗菌药物应用的合理性进行评价。方法选取医院2011年1月-2015年1月期间1 026例四肢闭合性骨折Ⅰ类切口手术患者,根据入院时间分为观察组474例与对照组552例,对照组术前、术后均给予预防性抗菌药物使用,观察组术前不给予预防性抗菌药物应用,仅于术后24h内酌情给予预防性抗菌药物应用一次,比较两组患者临床指标。结果两组患者术前、术后体温、WBC、中性粒细胞百分比比较差异均无统计学意义;观察组术前无预防性抗菌药物应用,术后抗菌药物使用率为7.59%,显著低于对照组的51.45%(P<0.05);两组手术时间、术中出血量、住院时间比较差异均无统计学意义,观察组患者住院费用显著低于对照组(P<0.05)。结论对于四肢闭合性骨折Ⅰ类切口手术患者,预防性抗菌药物应用应严格把握用药指征和用药时间,非必要情况下避免联合用药。OBJECTIVE To investigate the application of antimicrobial agents in patients with closed fractures of extremities with type Ⅰ incision before ＂ antimicrobial application special rectification activities＂,then compare with after the activities,to evaluate the rationality of the application of antimicrobial agents in closed incision fractures of extremities with type Ⅰ incision.METHODS A total of 1026 cases of closed fractures of extremities with type Ⅰ incision from Jan.2011 to Jan.2015 were selected,and divided into observation group（after ＂antimicrobial application special rectification activities＂,n=474）and control group（before ＂antimicrobial application special rectification activities＂,n=552）.Patients in control group were given prophylactic use of antimicrobial agents before and after the operation,and in observation group were not given prophylactic use of antimicrobial agents before the operation,only given within 24 hafter the operation under the necessity.The clinical indexes between the two groups were compared.RESULTS There was no significantly difference in body temperature,WBC and neutrophil percentage before and after the operation.There was no prophylactic use of antimicrobial agents in observation group before surgery,and postoperative usage rate of antibiotics was 7.59% ,which was significantly lower than51.45% in control group（P〈0.05）.There was no significantly difference in operation time,intraoperative blood loss and hospitalization time between the two groups,and the medical expense in observation group was significantly lower than that in control group（P〈0.05）.CONCLUSIONProphylactic use of antimicrobial agents should strictly grasp the medication indications and medication time in patients with closed fracture of extremities with type Ⅰ incision surgery,and unnecessary combination usage of drugs should be avoided.

关 键 词：四肢闭合性骨折 Ⅰ类切口 抗菌药物 调查 

分 类 号：R683.4[医药卫生—骨科学]