综合干预对骨科Ⅰ类切口围手术期预防使用抗菌药物效果分析
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摘要
目的探讨综合干预对骨科Ⅰ类切口围手术期预防使用抗菌药物的影响。方法抽取宣城市人民医院2017年1—12月Ⅰ类切口手术病例599份,与2016年数据进行对比,并对干预后预防性抗菌药物合理性进行评价分析,对比干预效果。结果下降至46.24%,差异有统计学意义(χ2=22.216,P<0.001)。预防用人均抗菌药物费用由对照组的189.16元下降为79.53元,住院总药费由对照组的2 496.62元下降为1 605.39元(P<0.001)。药物品种选择及术后用药时间的不合理给药频次较去年同期明显减少(P<0.01)。结论综合干预使该院骨科Ⅰ类切口手术预防性使用抗菌药物情况明显好转,对促进临床安全、有效、经济地应用抗菌药物起到积极作用。
Objective To evaluate the effects of comprehensive intervention on perioperative antimicrobial prophylaxis in the orthopedic Itype incision operation.Methods 599 I-type incision operation cases were extracted in Xuancheng People's Hospital from January to December 2017. In order to examine effects of intervention, the rationality of preventive anti-bacterial drugs was evaluated after intervention and compared with that of 2016. Results In 2017, rationality of anti-bacterial preventive medication was improved and its utilization rate was significantly reduced from 59.46% to 46.24%(χ2 = 22.216, P < 0.001). The cost of per capita antiseptic drugs decreased from 189.16 yuan to 79.53 yuan, and the cost of total inpatient drugs decreased from 2 496.62 yuan to 1 605.39 yuan(P< 0.001).Utilization frequency of irrational drugs also obviously decreased in drugs selection and drugs use timing of post of operation(p<0.01). Conclusion The status of anti-bacterial preventive medication of 1-type incision operation in a certain hospital has gained favorable results through comprehensive intervention, and it has positive role on stimulating clinical anti-bacterial medication, which was safer, more effective and more economical.
Objective To evaluate the effects of comprehensive intervention on perioperative antimicrobial prophylaxis in the orthopedic Itype incision operation.Methods 599 I-type incision operation cases were extracted in Xuancheng People's Hospital from January to December 2017. In order to examine effects of intervention, the rationality of preventive anti-bacterial drugs was evaluated after intervention and compared with that of 2016. Results In 2017, rationality of anti-bacterial preventive medication was improved and its utilization rate was significantly reduced from 59.46% to 46.24%(χ2 = 22.216, P < 0.001). The cost of per capita antiseptic drugs decreased from 189.16 yuan to 79.53 yuan, and the cost of total inpatient drugs decreased from 2 496.62 yuan to 1 605.39 yuan(P< 0.001).Utilization frequency of irrational drugs also obviously decreased in drugs selection and drugs use timing of post of operation(p<0.01). Conclusion The status of anti-bacterial preventive medication of 1-type incision operation in a certain hospital has gained favorable results through comprehensive intervention, and it has positive role on stimulating clinical anti-bacterial medication, which was safer, more effective and more economical.
引文
[1]孙远南,张玲娣,蒋国军.骨科Ⅰ类切口手术预防性使用抗菌药物干预前后效果分析[J].中华临床感染病杂志,2012,5(4):230-231.
[2]刘隽,田卓平,张少明,等.多项举措改善I类切口手术围手术期抗菌药物应用[J].中国感染控制杂志,2016,15(6):422-425.
[3]杨静谟,徐维平,周芮伊,等.某院I类切口清洁手术围手术期预防用抗菌药物合理性分析[J].安徽医药,2015,19(10):2028-2030.
[4]覃金爱,黄小红,黄娟,等.清洁切口手术围手术期抗菌药物预防性应用的干预与成效[J].中华医院感染学杂志,2011,21(12):2562-2564.
[5]宋攀,黄垂国,李云龙,等.抗菌药物在外科的不合理应用及对策[J].中华医院感染学杂志,2017,27(3):717-720.
[6]庞晓军,赖广平,邓忠南,等.无高危因素的三种清洁手术预防用药[J].中国医院药学杂志,2011,31(21):1793-1794.
[7]史庆丰,张尧,孙伟,等.2013-2016年上海市86所医院I类切口围术期抗菌药物预防应用调查分析[J].中华医院感染学杂志,2017,27(24):5604-5607.
[8]潘京京,孙萌,王惠川,等.西安市14所医院I类手术切口抗菌药物预防性应用分析[J].中华医院感染学杂志,2016,26(6):1397-1399,1403.
[9]《抗菌药物临床应用指导原则》修订工作组.抗菌药物临床应用指导原则(2015年版)[M].北京:人民卫生出版社,2015.
[10]国家卫生计生委医政医管局、国家卫生计生委合理用药专家委员会(编写组).国家抗微生物治疗指南[M].2版.北京:人民卫生出版社,2017.
[11]KHAN UD.Breast augmentation,antibiotic prophylaxis,and infection:comparative analysis of 1,628 primary augmentation mammoplasties assessing the role and efficacy of antibiotics prophylaxis duration[J].Aesthetic Plastic Surgery,2010,34(1):42-47.
[12]史志学.外科I类切口手术围术期预防性应用抗菌药物的情况调查以及合理性分析[J].中国医院用药评价与分析,2016,16(2):231-234.
[13]李明真,张国柱,韦邦年.药学干预对骨科I类切口手术预防用抗菌药物的效果分析[J].安徽医药,2014,18(5):973-975.
[2]刘隽,田卓平,张少明,等.多项举措改善I类切口手术围手术期抗菌药物应用[J].中国感染控制杂志,2016,15(6):422-425.
[3]杨静谟,徐维平,周芮伊,等.某院I类切口清洁手术围手术期预防用抗菌药物合理性分析[J].安徽医药,2015,19(10):2028-2030.
[4]覃金爱,黄小红,黄娟,等.清洁切口手术围手术期抗菌药物预防性应用的干预与成效[J].中华医院感染学杂志,2011,21(12):2562-2564.
[5]宋攀,黄垂国,李云龙,等.抗菌药物在外科的不合理应用及对策[J].中华医院感染学杂志,2017,27(3):717-720.
[6]庞晓军,赖广平,邓忠南,等.无高危因素的三种清洁手术预防用药[J].中国医院药学杂志,2011,31(21):1793-1794.
[7]史庆丰,张尧,孙伟,等.2013-2016年上海市86所医院I类切口围术期抗菌药物预防应用调查分析[J].中华医院感染学杂志,2017,27(24):5604-5607.
[8]潘京京,孙萌,王惠川,等.西安市14所医院I类手术切口抗菌药物预防性应用分析[J].中华医院感染学杂志,2016,26(6):1397-1399,1403.
[9]《抗菌药物临床应用指导原则》修订工作组.抗菌药物临床应用指导原则(2015年版)[M].北京:人民卫生出版社,2015.
[10]国家卫生计生委医政医管局、国家卫生计生委合理用药专家委员会(编写组).国家抗微生物治疗指南[M].2版.北京:人民卫生出版社,2017.
[11]KHAN UD.Breast augmentation,antibiotic prophylaxis,and infection:comparative analysis of 1,628 primary augmentation mammoplasties assessing the role and efficacy of antibiotics prophylaxis duration[J].Aesthetic Plastic Surgery,2010,34(1):42-47.
[12]史志学.外科I类切口手术围术期预防性应用抗菌药物的情况调查以及合理性分析[J].中国医院用药评价与分析,2016,16(2):231-234.
[13]李明真,张国柱,韦邦年.药学干预对骨科I类切口手术预防用抗菌药物的效果分析[J].安徽医药,2014,18(5):973-975.