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作 者:周楠[1] 丰航[1] 惠娇娇 李黎[1] 张丹[1] 张鹏[1] ZHOU Nan;FENG Hang;HUI Jiaojiao;LI Li;ZHANG Dan;ZHANG Peng(Department of Pharmacy,Shaanxi Provincial People′s Hospital,Xi′an 710068,China)
出 处:《西北药学杂志》2018年第5期672-674,共3页Northwest Pharmaceutical Journal
基 金:国家自然科学基金项目(编号:81703514)
摘 要:目的研究规范骨科Ⅰ类切口围术期抗菌药物的预防使用对术后发生手术部位感染(SSI)的影响。方法系统筛选出2016全年骨科Ⅰ类切口手术病例,1~6月病例为干预前组,7~12月病例为干预后组,对抗菌药物的品种选择、用药时机、术后用药疗程和SSI率进行统计。对SSI相关危险因素进行筛查和分析,通过Logistic线性回归分析筛查结果。结果干预前后研究对象中男女比例、年龄和住院时间比较差异均无统计学意义。干预后,抗菌药物的预防使用更加规范化。预防用抗菌药物的品种选择已基本合理;用药时机正确率由84.15%上升至99.10%;术后用药疗程由干预前2.22d降至1.58d;差异均具有统计学意义;SSI发生率降低。SSI发生率与手术时间大于3h、患者合并高血压或糖尿病有密切相关性。术中是否追加抗菌药物对SSI有影响。结论临床药师通过干预围术期抗菌药物的不合理使用,可降低术后SSI的发生率,但在术中追加抗菌药物方面还需加强干预及宣教。Objective To study the effect of clinical pharmacist intervention on postoperative surgical site infection (SSI) by standardized antimicrobial prophylaxis in orthopedic type Ⅰ incision operation. Methods Orthopedic aseptic operation in 2016 were selected.Patients between January and June were selected as pre-intervention group and patients between July and December were selected as post-intervention group.Prophylactic use of antibiotics,drugs selection,time of using antibiotics,medication course of prophylactic antibiotics hospital stay and SSI were compared between the 2 groups.The SSI related risk factors were screened and analyzed by Logistic linear regression to discover new problems. Results There was no significant difference in proportion of gender or age for prophylactic use of antibiotics between the 2 groups.Antimicrobial drugs selection had become reasonable after intervention.The correct opportunity of prophylactic antibiotics usage was risen from 84.15% in the pre-intervention to 99.10% in the post-intervention.Medication course of prophylactic was reduced from 2.22 d in the pre-intervention to 1.58 d in the post-intervention.These all had statistical difference between the 2 groups.SSI were reduced. However,it was low in the rate of re-dosing of antibiotics on prevention and detection.The infection rate of the additional antibiotics group was lower than that of the group without additional antibiotics. The incidence of SSI was closely related to the operation time more than 3 h,the patients with hypertension or diabetes mellitus.In addition,intraoperative addition of antimicrobial agents had an effect on SSI. Conclusion Clinical pharmacist intervention in antimicrobial prophylaxis in orthopedic type Ⅰ incision operation could reduce SSI.However,it still needs to strengthen the training and management to the rate of re-dosing of antibiotics on prevention.
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