关节镜手术围手术期抗菌药物应用的干预效果

目的了解某院关节镜手术干预前后围手术期预防性抗菌药物使用情况，评价干预效果，为规范临床合理使用抗菌药物提供依据。方法2012年8月起采取措施干预围手术期抗菌药物应用，对2011年9月—2013年8月该院312例关节镜手术患者围手术期抗菌药物的使用及手术切口感染情况进行回顾性调查。结果共调查患者312例，干预前150例，干预后162例，干预前后切口感染发病率均为0。干预后抗菌药物使用率为26.54%，低于干预前的100.00%，差异有统计学意义(χ2=1.781,P＜0.001)。不合理预防性使用抗菌药物的现象明显改善，平均抗菌药物费用比较，差异有统计学意义（t=3.330，P＜0.001），由干预前的（1 165.69±756.33）元，下降至干预后的（32.71±119.29）元。结论干预后该院关节镜手术围手术期抗菌药物使用率明显下降，用药合理性提高，仍保持切口零感染。

Intervention efficacy of perioperative antimicrobial use in arthroscopic surgery

ObjectiveTo investigate perioperative antimicrobial prophylaxis in arthroscopic surgery in a hospital before and after intervention, evaluate intervention efficacy, and provide evidence for the rational clinical antimicrobial application.MethodsFrom August 2012, measures were taken to intervene perioperative antimicrobial use, perioperative antimicrobial use and surgical site infection(SSI) in 312 patients undergoing arthroscopic surgery between September 2011 and August 2013 were retrospectively surveyed.ResultsA total of 312 patients were investigated, pre and post intervention were 150 and 162 cases respectively, SSI rates were both 0 before and after intervention. Antimicrobial usage rate after intervention was lower than before intervention (26.54% vs 100.00%， χ2=1.781,P＜0.001). Irrational antimicrobial use dropped obviously；average expense of antimicrobial agents dropped from (1 165.69±756.33) yuan (RMB) before intervention to (32.71 ±119.29)yuan (RMB) after intervention (t=3.330, P＜0.001).ConclusionPerioperative antimicrobial usage rate in arthroscopic surgery at this hospital decreased significantly after intervention, rational use of antimicrobial agents has improved, SSI rate still remains zero.