干预前后3种清洁手术围手术期预防用抗菌药分析

目的：评价某院3种清洁手术（腹外疝、甲状腺、乳腺）围手术期预防用抗茵药的合理性与实施干预措施的效果。方法：采用回顾性调查方法，抽取2011年4月出院的3种清洁手术病历68份为干预前组，2012年9月出院病历76份为干预后组，对围手术期预防用抗菌药情况进行统计分析。结果：3种清洁手术围手术期抗茵药使用率干预前为100．0％，干预后为27．6％（P〈0．05）；无指征用药从干预前的80．9％下降~1]38．1％（P〈0．05）；药物选择合理率A,k22．1％上升至90．5％（P〈0．05）；用药时机合理率．z＆41．2％上升至95．2％（P〈0．05）；术后用药疗程〉24h的患者比例从干预前的58．8％下降到干预后的14．3％（P〈0．05）。结论：采取合理、有效的干预措施，能促进I】盘床抗菌药合理使用。

Analysis of Intervention of Perioperative Prophylactic Application of Antibiotics in Three Kinds of Clean Operation

Objective ： To evaluate the rationality and effectiveness of intervention measures on prophylactic appli- cation of antibiotics during perioperative period of three kinds of clean operation including repairing hernia surgery, thyroid surgery and breast surgery. Methods： With the method of retrospective survey, 68 cases of three kinds of clean operations in April. 2011 were sampled as the pre-intervention group and 76 cases in Sept. 2012 as the post-intervention group. The in- vestigation and analysis were performed on prophylactic application of antibiotics during the perioperative period. Results： The percentage of antibiotics use of three kinds of clean operation was much lower, from 100% before the intervention to 27.6% after the intervention （ P 〈 0.05 ）. The percentage of no indication antibiotics use also went from 80.9% down to 38.1% （ P 〈 0.05 ）. Compared with the pre-intervention group, rationality of the perioperative prophylactic application of antibiotics in three kinds of clean operation in the post-intervention group was significantly improved in respect of the choice of antibiotics usage and medication timing, the percentage of which increased from 22.1% to 90.5% （P 〈 0.05 ） and from 41.2% to 95.2% （P 〈 0.05）, while the percentage of the postoperative antibiotics treatment time （ 〉 24 h） decreased from 58.8% before the intervention to 14.3% after it（ P 〈 0.05 ）. Conclusion： The rational and effective intervention measures contributed to the clinical rational use of antibiotics drug.