干预前后骨科Ⅰ类切口手术抗菌药使用调查

目的：分析骨科在抗菌药专项整治前后Ⅰ类切口手术患者抗菌药应用情况，为加强药物合理使用和规范管理提供依据。方法：分别提取2012年10～12月（干预后）及2010年10～12月（干预前）骨科病房出院的所有Ⅰ类切口手术病历，调查两组抗菌药应用情况，同时对限制抗菌药应用后Ⅰ类切口感染率和人均住院药费进行统计学比较。结果：专项整治后骨科Ⅰ类切口手术抗菌药预防使用率＜30%，86.37%抗菌药使用时间＜48 h，且人均住院天数和切口感染率无明显差异，但仍有13.43%病例存在用药疗程过长，9.45%用药指征不明确，22.39%药物品种选择不当等问题。结论：抗菌药在该院骨科的应用趋于合理，保持这一良好势态并持续改进尚需继续做出努力。

Investigation of the Use of Antimicrobial Drugs in Orthopedics Patients with Type I Incision Before and After the Special Rectification

Objective：To analyze antibiotics used by orthopedics patients with typeⅠincision before and after the special rectification so as to provide some more evidences for rational antibiotic usage and standard antibiotic administration.Methods：All Class Ⅰ incision medical records of discharged patients were extracted from the orthopedic ward from October to December in 2012 and 2010. The use of antimicrobial agents, of the two groups was investigated and their wound infection rate for Class Ⅰ and per capita medical expenses were statistically analyzed.Results： After the special rectification,fewer than 30% patients used antibiotics, and their medication time was less than 48h. There was no significant difference in the per capita length of stay and wound infection rate. But 13.43% of the cases had a long course of drugs, 9.45% medication indications were not clear, and 22.39% drug species selection was improper. Conclusion：In the hospital orthopedic, antimicrobial agents became more reasonable,but efforts still needed to be made to maintain or improve this status.