临床路径对小儿神经外科I类切口手术患者围术期抗菌药物预防性使用的影响  

Impact of Clinical Pathway on Perioperative Prophylactic Use of Antibacterial Drugs in Pediatric Neurosurgery Patients Undergoing Class I Incision Surgery

作　　者：黄辉云 袁海平 HUANG Hui-yun;YUAN Hai-ping(Xinfeng County Traditional Chinese Medicine Hospital,Ganzhou Jiangxi 341600,China)

机构地区：[1]信丰县中医院,江西赣州341600

出　　处：《抗感染药学》2023年第9期918-921,共4页Anti-infection Pharmacy

摘　　要：目的:评价临床路径对医院小儿神经外科I类切口手术患者围术期抗菌药物预防性使用的影响,为临床手术患者的抗菌药物合理使用提供参考。方法:选取2020年8月—2021年7月(实施临床路径前,48例)和2021年8月—2022年7月(实施临床路径后,48例)医院小儿神经外科收治的96例I类切口手术患者作为研究对象,比较和分析临床路径实施前后患者围术期预防用抗菌药物的品种、用药时机、用药疗程等情况,并对抗菌药物的合理用药状况进行评价和分析。结果:手术患者临床路径实施后预防性使用抗菌药物较实施前略有减少(32例vs 36例),但在抗菌药物品种选择方面存在较大不同(P<0.05);在用药时机方面,实施临床路径前后亦有明显差异(P<0.05),并且实施临床路径后用药时机为术前30~60 min的例数较前明显增加(26例vs 8例,P<0.05);在用药疗程方面,实施临床路径前后亦有明显差异(P<0.05),其中实施临床路径后疗程≤24 h的例数较前明显增加(27例vs 15例,P<0.05),而疗程>24 h的例数则较前明显减少(3例vs 16例,P<0.05);实施临床路径后,患者在品种选择、用药时机、用药疗程和术中该追加而未追加等方面的不合理使用情况较前都明显减少(P<0.05)。结论:临床路径的实施确实有效改善了医院小儿神经外科I类切口手术患者围术期抗菌药物预防性使用的不合理使用情况,从而提升了医院的抗菌药物合理用药水平,进而保障了患者的用药安全。Objective:To evaluate the impact of a clinical pathway on the perioperative prophylactic use of antibacterial drugs in pediatric neurosurgery patients undergoing Class I incision surgery,and provide a reference for the rational use of antibacterial drugs in clinical surgical patients.Methods:96 patients undergoing Class I incision surgery admitted to the pediatric neurosurgery department of the hospital from August 2020 to July 2021(48 cases before implementing the clinical pathway)and from August 2021 to July 2022(48 cases after implementing the clinical pathway)were selected as the research subjects.The variety,medication timing,and medication duration of perioperative prophylactic antibacterial drugs used by the patients before and after implementing the clinical pathway were compared and analyzed,and the rational use of the antibacterial drugs was evaluated and analyzed.Results:After the implementation of the clinical pathway for surgical patients,there was a slight decrease in the prophylactic use of antibacterial drugs compared to that before implementation(32 cases vs 36 cases),but the varieties of antibacterial drugs were greatly different(P<0.05).In terms of medication timing,there were also significant differences before and after implementing the clinical pathway(P<0.05),and the number of cases with medication timing of 30-60 minutes before surgery after implementing the clinical pathway increased significantly compared to that before implementation(26 cases vs 8 cases,P<0.05).In terms of medication duration,there were also significant differences before and after implementing the clinical pathway(P<0.05).Among them,the number of cases with a treatment period of not more than 24 hours after implementing the clinical pathway increased significantly compared to that before(27 cases vs 15 cases,P<0.05),while the number of cases with a treatment period of more than 24 hours decreased significantly compared to that before(3 cases vs 16 cases,P<0.05).After implementing the clinical pathway,the irrational use

关 键 词：I类切口手术 临床路径 抗菌药物预防使用 小儿神经外科 

分 类 号：R969.3[医药卫生—药理学] R978.1[医药卫生—药学]