县医院I类切口手术预防用抗菌药物合理应用的影响因素*

目的:探讨与分析影响县医院Ⅰ类切口手术预防用抗菌药物合理应用的因素,以促进抗菌药物的合理使用。方法:收集2018年6月到2019年6月在本院进行Ⅰ类切口手术的患者2131例,调查患者的一般资料与预防用抗菌药物使用情况。结果:2018年第三季度、第四季度Ⅰ类切口手术抗菌药物预防使用率分别为40.5%、33.73%;2019年第一季度、第二季度Ⅰ类切口手术抗菌药物预防使用率分别为24.0%、25.0%。在2131例患者中,合理用药892例,合理率为41.9%;不合理用药1239例,不合格率为58.1%。单因素分析显示,基础疾病、手术时机、年龄、支付费用方式均为影响合理用药的重要因素(P<0.05)。多因素Logistic回归分析显示,基础疾病、手术时机、年龄、支付费用方式为影响县医院Ⅰ类切口手术预防用抗菌药物合理应用的危险因素(P<0.05)。结论:县医院Ⅰ类切口手术预防用抗菌药物的不合理用药比例较高,多为使用时机、使用疗程不当,基础疾病、手术时机、年龄、支付费用方式为主要的影响因素。

Analysis of Factors Affecting the Rational Application of Antibacterial Drugs for Prevention of Type I Incision Surgery in County Hospitals*

Objective: To investigate the factors affecting the rational application of antibacterial drugs for prevention of type Ⅰ incision surgery in county hospitals. Method: From July 2018 to June 2019, a total of 2131 cases of patients who underwent type Ⅰ incision surgery in our hospital were selected. The general information of the patients and the use of antibiotics for prevention were investigated. Results: In the third quarter and fourth quarter of 2018, the antibacterial prophylaxis rates of type Ⅰ incision surgery were 40.5% and 33.73%, respectively. In the first quarter and second quarter of 2019, the antibacterial prophylaxis rates of type Ⅰ incision surgery were 24.0% and 25.0%, respectively. There were 892 cases of rational use and 1239 cases of unreasonable use that the reasonable drug use rate was 41.9%. Univariate analysis showed that the underlying disease, timing of surgery, age, and payment method were important factors influencing rational drug use (P<0.05). Multivariate logistic regression analysis showed that the underlying diseases, timing of surgery, age, and payment method were all risk factors for the rational application of antibiotics for prevention of type Ⅰ incision surgery in county hospitals (P<0.05). Conclusion: The proportion of irrational use of antibiotics for prevention of type Ⅰ incision surgery in county hospitals is relatively high that mostly due to the timing of use and improper use of treatment, basic diseases, timing of surgery, age and payment methods.