蒋廷媛



Ⅰ、Ⅱ类切口围手术期抗菌药物合理应用分析

蒋廷媛

目的评价我院Ⅰ、Ⅱ类切口围手术期抗菌药物应用合理性及干预效果。方法选择2013年1～12月我院Ⅰ、Ⅱ类切口患者478例，以2013年1～6月的237例为对照组，2013年7～12月的241例为观察组。对照组围手术期抗菌药物的应用未给予干预措施；观察组围手术期抗菌药物应用时，实施干预性管理措施。比较两组围手术期抗菌药物应用合理性及效果。结果观察组围手术期抗菌药物应用合理率明显高于对照组（P＜0.05）；两组医院感染发生率无显著差异（P＞0.05）；观察组住院天数、住院费用、抗菌药物费用均少于对照组（P＜0.05）。结论Ⅰ、Ⅱ类切口围手术期抗菌药物应用的规范化管理，有助于提高抗菌药物应用的合理性，降低患者的住院费用。

围手术期；抗菌药物；合理性；规范

[Abstract]Objective To evaluate the rationality and intervention effect of perioperative rational use of antibacterials for typeⅠandⅡincisions.Methods 478 patients with typeⅠandⅡincisions treated between January and December 2013 were selected,in which 237 patients treated between January and Junewere chosen as control group and another 241 patients treated between July and December were chosen as observation group.In the control group,intervention measures were not given during the perioperative application of antibacterials.In the observation group,when perioperative antibacterials were used,the intervention management measures were implemented.The rationality and effects of perioperative antibacterial use were compared between the two groups. Results The reasonable rate of perioperative antibacterial application in the observation group was significantly higher than that in the control group(P＜0.05).There was no significant difference in the incidence rate of nosocomial infection between the two groups (P＞0.05).The length of stay,hospitalization expenses,and cost of antibacterials in the observation group were less than those in the control group(P＜0.05).Conclusion Standardized management of perioperative antibacterial use for typeⅠandⅡincisions helps to improve the rationality of antibacterial use and reduce hospitalization expenses of patients.

1　对象与方法

1.1研究对象选择2013年1～12月我院Ⅰ、Ⅱ类切口患者478例，其中男304例，女174例，年龄16～80（38.7±7.9）岁。Ⅰ类切口手术包括乳腺手术、甲状腺手术、疝修补术，Ⅱ类切口手术包括单纯胆囊切除术、剖宫产术、子宫及附件手术。以2013年1～6月的237例为对照组，其中男151例，女86例，平均（38.4±8.3）岁；Ⅰ类切口手术125例，Ⅱ类切口手术112例。以2013年7～12月的241例为观察组，其中男153例，女88例，平均（38.9±8.1）岁；Ⅰ类切口手术130例，Ⅱ类切口手术111例。两组性别比、年龄、手术切口类型差异无统计学意义（P＜0.05）。

1.2围手术期抗菌药物应用干预措施对照组围手术期抗菌药物应用未给予干预措施；观察组围手术期抗菌药物应用时，给予下列相应干预措施。

1.2.1建立管理制度成立以医院院长、分管副院长、医务科负责人、感染科负责人、药剂科负责人、临床专家为主要成员的管理小组，制定抗菌药物临床应用管理规范，以及相应的质量评价及奖惩制度等。……