分阶段评估对Ⅰ类切口手术围手术期抗菌药物预防应用的影响  

Effect of staged evaluation on the preventive application of antibiotics in perioperative patients undergoing type Ⅰ incision surgery

作　　者：陈红 张艳 武斌 鞠媛媛 闫国萍 明明[2] CHEN Hong;ZHANG Yan;WU Bin;JU Yuanyuan;YAN Guoping;MING Ming(Department of Infection Management,Shandong Second Rehabilitation Hospital,Tai'an,Shandong,271000,China;Tai'an Disease Prevention and Control Center,Tai'an,Shandong,271000,China)

机构地区：[1]山东省第二康复医院感染管理科,山东泰安271000 [2]泰安市疾病预防控制中心免疫规划科,山东泰安271000

出　　处：《当代医学》2024年第5期159-162,共4页Contemporary Medicine

基　　金：山东省医药卫生科技项目(202315021662);泰安市科技创新发展计划(2020NS200)。

摘　　要：目的探讨分阶段评估对Ⅰ类切口手术围手术期患者抗菌药物预防应用情况的影响。方法选取2019年1—12月于山东省第二康复医院行Ⅰ类切口手术的150例患者作为干预前组,另选取2020年8月至2021年7月行Ⅰ类切口手术的150例患者作为干预后组。采用回顾性调查和前瞻性监测方法,收集患者临床资料、术前准备、术中、术后感染风险指标,设计围手术期Ⅰ类切口感染风险评估调查表,评估围手术期Ⅰ类切口感染风险,比较两组手术部位感染风险评估依从率、评估完整率及围手术期抗菌药物预防性应用情况。结果干预后组手术部位感染风险评估依从率、评估完整率均高于干预前组,差异有统计学意义(P<0.05)。两组无适应证预防用药占比比较差异无统计学意义;干预后组术后预防用药优于干预前组,差异有统计学意义(P<0.05)。结论分阶段评估对Ⅰ类切口手术围手术期抗菌药物,强化了合理用药责任意识,规范了预防用药行为,减少过度依赖抗菌药物预防手术部位感染,使Ⅰ类切口手术患者抗菌药物预防应用更加规范和个体化。Objective To investigate the effect of staged evaluation on the preventive application of antibiotics in perioperative patients undergoing typeⅠincision surgery.Methods A total of 150 patients who underwent typeⅠincision surgery in the Shandong Second Rehabilitation Hospital in the Province from January to December 2019 were selected as the pre-intervention group,and 150 patients who underwent typeⅠincision surgery from August 2020 to July 2021 were selected as the post-intervention group.Retrospective investigation and prospective monitoring methods were used to collect clinical data,preoperative preparation,intraoperative and postoperative infection risk indicators of patients,the perioperative typeⅠincision infection risk assessment questionnaire was designed to evaluate the risk of perioperative typeⅠincision infection,the compliance rate of surgical site infection risk assessment,the integrity rate of assessment and the preventive application of antibiotics during perioperative period were compared between the two groups.Results The compliance rate and integrity rate of surgical site infection risk assessment in the post-intervention group were higher than those in the pre-intervention group,and the differences were statistically significant(P<0.05).There was no significant difference in the proportion of non-indication preventive medication between the two groups;the postoperative preventive medication in the post-intervention group was better than that in the pre-intervention group,and the difference was statistically significant(P<0.05).Conclusion The phased evaluation of perioperative antibiotics for typeⅠincision surgery has transformed the sense of responsibility for rational drug use,standardized the behavior of preventive medication,reduced the excessive dependence on antibiotics to prevent surgical site infection,and made the preventive application of antibiotics in patients with typeⅠincision surgery more standardized and individualized.

关 键 词：Ⅰ类切口手术 分阶段评估 抗菌药物预防性应用 

分 类 号：R95[医药卫生—药学]