药学干预对骨科Ⅰ类切口抗菌药物预防使用情况的影响  

Effect of pharmaceutical intervention on preventive use of antibiotics of classⅠincision in orthopedics

作　　者：沈倩影 张琳[1] SHEN Qianying;ZHAGN Lin(Pharmacy Department,Maternity and Child Health Hospital Affiliated to Nantong University,Nantong 226018,China)

机构地区：[1]南通大学附属妇幼保健院药事科,江苏南通226018

出　　处：《临床医学研究与实践》2021年第32期189-191,共3页Clinical Research and Practice

基　　金：国家自然科学基金资助项目(No.81870941);2020年度南通市卫生健康委员会科研课题(No.MB2020043)。

摘　　要：目的探讨药学干预对骨科Ⅰ类切口抗菌药物预防使用情况的影响。方法随机抽取2017年本院收治的274例骨科Ⅰ类切口手术患者作为对照组(未经药学干预),2019年本院收治的351例骨科Ⅰ类切口手术患者作为观察组(经药学干预)。比较两组抗菌药物预防使用情况。结果观察组抗菌药物预防总使用率低于对照组(P<0.05)。对照组预防使用的抗菌药物种类以第三代头孢菌素为主,观察组以第一、二代头孢菌素为主,两组喹诺酮类抗菌药物、其他β-内酰胺类/β-内酰胺酶抑制剂预防使用率无显著差异(P>0.05)。两组术前给药时机及疗程比较,差异具有统计学意义(P<0.05);观察组术中追加抗菌药物患者占比高于对照组,差异具有统计学意义(P<0.05);两组术后用药疗程在>48~72 h的患者占比无显著差异(P>0.05),其余用药疗程的患者占比均具有显著差异(P<0.05)。两组术后切口感染发生率比较,差异无统计学意义(P>0.05)。结论药学干预在骨科Ⅰ类切口抗菌药物预防使用方面发挥了重要作用,能够促使抗菌药物预防使用趋于合理,值得临床应用推广。Objective To explore the effect of pharmaceutical intervention on preventive use of antibiotics of classⅠincision in orthopaedic.Methods A total of 274 patients admitted in our hospital in 2017 were randomly selected as control group(without pharmaceutical intervention),and 351 patients admitted in our hospital in 2019 were selected as observation group(pharmaceutical intervention),and the preventive use of antibiotics were compared between the two groups.Results The total preventive use rate of antibiotics in the observation group was lower than that in the control group(P<0.05).The types of antibiotics used for prevention in the control group were mainly the third generation cephalosporins,and the observation group was mainly the first and second generation cephalosporins.There were no significant differences in the preventive use rate of quinolones and other β-lactams/β-lactamase inhibitors between the two groups(P>0.05).There were significant differences in preoperative timing of administration and course of treatment between the two groups(P<0.05);the proportion of patients with additional antibiotics during operation in the observation group was higher than that in the control group,and the difference was statistically significant and promotion(P<0.05);there was no significant difference in the proportion of patients with the course of postoperative medication at>48-72 h between the two groups(P>0.05),and there were significant differences in the other courses of medication(P<0.05).There was no significant difference in the incidence of postoperative incision infection between the two groups(P>0.05).Conclusion Pharmaceutical intervention plays an important role in prevention use of antibiotics of classⅠincision in orthopedics,it can promote the rational use of antibiotics,which is worthy of clinical application.

关 键 词：药学干预 骨科Ⅰ类切口 抗菌药物 预防使用 给药时机 疗程 切口感染 

分 类 号：R619[医药卫生—外科学]