新版《抗菌药物临床应用指导原则》干预妇产科Ⅱ类切口手术的实施效果  

Implementation effect of Guidelines for Clinical Use of Antibacterials (new version) in intervention of type Ⅱ incision gynecological and obstetric surgery

作　　者：江莉[1] 胡君 欧阳越 蔡庆顺[1] 李勤[1] 庄元[1] JIANG Li;HU Jun;OUYANG Yue;et al(Jiangxi Maternal and Child Health Hospital, Nanchang, Jiangxi 330006, Chin)

机构地区：[1]江西省妇幼保健院,江西南昌330006

出　　处：《中国妇幼保健》2017年第24期6061-6064,共4页Maternal and Child Health Care of China

基　　金：江西省卫生计生委科技计划立项课题(20175472)

摘　　要：目的分析《抗菌药物临床应用指导原则(2015版)》干预妇产科Ⅱ类切口手术预防性使用抗菌药物的实施效果。方法抽取江西省妇幼保健院干预前的2012年1月-2015年8月、干预后的2015年9月-2017年3月行妇产科3种Ⅱ类切口手术患者各180例,调查研究干预前、后围术期预防应用抗菌药物的种类、抗菌药物使用率、给药疗程、联合用药及术后感染情况。结果依据《抗菌药物临床应用指导原则(2015版)》干预后,妇产科Ⅱ类切口围手术期预防性使用抗菌药物品种较为合理,大多选用第一、二代头孢菌素,第三代头孢菌素头孢噻肟钠的使用率从3.33%下降至0.00%,头孢曲松钠的使用率从9.44%下降至0.00%;抗菌药物使用时间24 h内病例比例由33.33%上升至77.22%,抗菌药物使用时间48 h内病例比例由49.44%下降至13.33%;与干预前组患者比较差异均有统计学意义(P<0.05)。干预前、后两组患者Ⅱ类切口感染发生率分别为2.22%、1.67%,两组差异无统计学意义(P>0.05)。结论根据《抗菌药物临床应用指导原则(2015年版)》干预妇产科Ⅱ类切口手术预防性使用抗菌药物,有效限制了第三代头孢菌素用于围手术期预防用药,减少了该类手术抗菌药物预防应用时间,并未增加感染的风险。Objective To analyze the implementation effect of prophylactic use of antibiotics according to Guidelines for Clinical Use of Antibacterials （published in 2015） in intervention of type Ⅱ incision gynecological and obstetric surgery.Methods A total of 180 patients undergoing three kinds of type Ⅱ incision gynecological and obstetric surgery before intervention （from January 2012 to August 2015） and 180 patients undergoing three kinds of type Ⅱ incision gynecological and obstetric surgery after intervention （from September 2015 to March 2017） were selected from Jiangxi Maternal and Child Health Hospital.The kinds of antibacterial drugs during perioperative period before and after intervention,usage rate of antibacterial drugs,treatment course,combination drug therapy,and postoperative infection were surveyed.Results According to Guidelines for Clinical Use ofAntibacterials （published in 2015）,the kinds of antibacterialdrugs for prophylactic use of type Ⅱ incision gynecological and obstetric surgery were reasonable after intervention.The first-generation cephalosporin and the second-generation cephalosporin were used by most clinicians,the usage rate of the third-generation cephalosporin （cefotaxime sodium） decreased from 3.33% to 0.00%,and the usage rate of ceftriaxone sodium decreased from 9.44% to 0.00%.The proportion of cases using antibacterial drugs within 24 hours increased from 33.33% to 77.22%,and the proportion of cases using antibacterial drugs within 48 hours decreased from 49.44% to 13.33%,compared with before intervention,there were statistically significant differences （P〈0.05）.The incidence rates of incision infection before and after intervention were 2.22% and 1.67%,respectively,there was no statistically significant difference （P〉0.05）.Conclusion Application of antibacterial drugs according to Guidelines for Clinical Use of Antibacterials （published in 2015） for type Ⅱ incision gynecological and obstetric surgery can effectively limit prophylactic use

关 键 词：抗菌药物临床应用指导原则(2015年版) 妇产科 Ⅱ类切口手术 干预 

分 类 号：R713[医药卫生—妇产科学]