普通外科Ⅰ类切口抗菌药物预防使用干预及与手术部位感染相关性

摘要

目的 比较干预前后普通外科3种Ⅰ类切口手术围手术期(围术期)预防用抗菌药物情况,分析围术期预防用抗菌药物与手术部位感染的相关性.方法 自2010年起,对普通外科手术中甲状腺、乳腺及疝修补3类手术围术期预防性使用抗菌药物进行干预,依据<普通外科Ⅰ类(清洁)切口手术围手术期预防用抗菌药物管理实施细则>制定措施限制抗菌药物的使用.比较干预前后抗菌药物使用情况及手术部位感染情况.结果 干预前,3种Ⅰ类切口手术围术期总抗菌药物使用率为21.28%(60/282),干预后为3.21%(15/468),两者比较,差异有统计学意义(χ2=63.85,P<0.05);平均住院天数,干预前为(4.09±2.99)d,干预后为(3.67±2.47)d,两者比较,差异有统计学意义(χ2=3.704,P=0.000);干预后使用的抗菌药物种类减少;干预前后手术部位感染率均为0.00%.结论 普通外科Ⅰ类切口手术围术期不预防使用抗菌药物,不会导致手术部位感染率增加.%Objective To compare correlation between preventive perioperative antimicrobial application and surgical site infection (SSI) of type I incision operation in a general surgery department. Methods Since 2010, preventive perioperative use of antimicrobial agents in thyroid surgery, breast surgery and hernia repair surgery has been intervened, a series of control measures on the use of antimicrobial agents have been established according to The detailed management rules of preventive perioperative antimicrobial agents use in type I incision operation in general surgery department. Difference in the use of antimicrobial agents and SSI rates before and after intervention were analyzed. Results The usage rate in three kinds of operations was 21. 28% (60/282) before intervention and 3. 21%(15/468) after intervention (X2 = 63. 85,P<0. 05) ; the average hospitalization day was (4. 09 ± 2. 99) d before intervention and (3. 67 + 2. 47)d after intervention(X2=3. 704,P= 0. 000) ; the types of antimicrobial agents decreased after intervention; SSI rate was both 0. 00% before and after intervention. Conclusion SSI won't increase if preventive perioperative antimicrobial agents aren't used in type I incision operation.