Ⅰ类切口手术围手术期抗菌药物预防使用综合干预对照研究

摘要

Objective To explore the effect of the comprehensive intervention in prophylactic use of anti-biotics during perioperative period of Type Ⅰ incision . T he rationality of the prophylactic application of antibiotics in Type I incision before and after pharma-ceutical care and administrative intervention was com-pared and analyzed by studying 1000 copies of medical record of patients receiving Type I incision in this hos-pital from January to October , 2012 before interven-tions and from December ,2012 to September ,2013) after interventions .Methods By a random sampling method ,the medical records of patients undergoing Ⅰ incision operations were collected from Jan .2012 to Oct .2012 (before intervention ,1000 cases) and from Dec .2012 to Sep .2013 (after intervention ,1000 cases) for statistical analysis .The rationality of the prophylactic application of antibiotics was compared before and after the intervention .Results After the comprehensive interventions ,the rate of prophylactic use of antibiotics decreased from 54 .4% to 48 .20% after intervention ( P <0 .05) ,the rate of reasonable variety selection increased from 81 .74% to 90 .19% after intervention( P <0 .05) ,the rate of reasonable medica-tion time increased from 78 .49% to 89 .91% after intervention( P <0 .05) ,the rate of the course of rea-sonable use of antibiotics increased from 42 .94% to 65 .97% after intervention ( P <0 .05) and the rate of combined use of drug decreased from 3 .24% to 0 after intervention ( P <0 .05) .Conclusion The compre-hensive intervention is feasible and can promote the preventive effect of using antibiotics during periopera-tive period .%目的：探索药学服务和行政干预在Ⅰ类切口手术围手术期预防性使用抗菌药物的实施效果。方法以随机抽样法调取干预前（2012年1月～2012年10月）和干预后（2012年12月～2013年9月）Ⅰ类切口手术出院病历各1000份，对比分析干预前、后Ⅰ类切口手术围手术期预防性使用抗菌药物的合理性。结果抗菌药物预防性使用率从干预前的54．4％下降为干预后的48．20％（ P ＜0．05），品种选择合理率从干预前的81．74％上升为干预后的90．19％（ P ＜0．05），用药时机合理率从干预前的78．49％上升为干预后的89．91％（ P ＜0．05），使用疗程合理率从干预前的42．94％上升为干预后的65．97％（ P ＜0．05），联合用药比率从干预前的3．24％下降为干预后的0（ P ＜0．05）。结论综合干预管理措施可行、有效，可以著提高Ⅰ类切口围手术期抗菌药物合理用药水平。