监测干预妇科手术抗菌药物预防性应用

目的探讨通过手术部位感染监测对妇科手术围手术期抗菌药物预防性应用进行干预的效果。方法以《围手术期预防应用抗菌药物指南》的条款作为评价指标，对696例妇科手术患者围手术期抗菌药物预防性应用情况进行检查评估，定期将监测结果和用药情况进行反馈。比较干预前后妇科手术抗菌药物预防性应用的变化。结果经干预后，手术前0.5～1 h的预防用药品种选择合理率由干预前的78.59%（334/425）上升至干预后的89.26%（241/270），两者比较，差异有统计学意义（χ2=13.20，P＜0.05）。预防用药疗程≤48 h的比率由干预前的3.32%（12/362）增加至干预后的44.98%（103/229），疗程＞72 h的比率由84.53%（306/362）下降至41.92%（96/229），两两比较，差异有统计学意义（P＜0.05）。结论通过手术部位感染监测采取干预措施能规范围手术期抗菌药物的预防性应用，使其品种选择合理性增加，预防用药疗程缩短。

Intervention in peri operative antimicrobial prophylaxis in gynecologic operation through surgical site infection surveillance

Objective To evaluate the intervention effect on peri-operative antimicrobial prophylaxis （PAP） in gy- necologic operation through surgical site infection surveillance. Methods PAP for 696 patients with gynecological operation was supervised according to the Guidelines of Peri-operative Antimicrobial Prophylaxis, feedback of surveillance results and antimicrobial application were performed. PAP in gynecologic operation before and after intervention was compared. Results The rate of rational choice of antimicrobial agents within 30-60 minutes before surgery increased from 78. 59% （334/425） of pre-intervention to 89. 26% （241/270） of post-intervention （ X^2 = 13.20, P〈0. 05）. The rate of prophylactic duration ≤ 48 hours increased from 3.32% （12/362） of pre-intervention to 44. 98% （103/229） of post-intervention, the rate of duration ≤72 hours decreased from 84. 53% （306/362） to 41.92% （96/229） （P〈0. 05）. Conclusion Intervention can standardize peri-operative antimicrobial prophylaxis, enhance the rational choice of antimicrobial agents and shorten the prophylactic duration.