手术部位感染目标性监测分析

目的了解某肿瘤医院Ⅰ类切口手术部位感染(SSI)情况,探讨持续监测及改进效果,为进一步干预提供依据。方法采取查阅病例、床旁观察、换药观察、成员随访的监测方法 ,对2013年1—6月某院甲状腺外科Ⅰ类切口手术患者进行SSI目标性监测,并与2010年同期监测结果进行对比。结果 2013年1—6月和2010年1—6月两次监测周期各发生1例SSI,SSI率分别为0.20%、0.18%,差异无统计学意义(P=1.000)。2013年1—6月,围手术期预防性使用抗菌药物率为0.20%,低于2010年的27.21%;抗菌药物用药指征符合率达100%,高于2010年的6.76%,差异均有统计学意义(均P0.001)。结论 SSI目标性监测有助于规范围手术期抗菌药物的使用,同时,降低抗菌药物预防用药率并不会增加Ⅰ类切口SSI率。

Targeted surveillance on surgical site infection

ObjectiveTo understand the occurrence of surgical site infection (SSI) following class I incision operation in a tumor hospital, explore the continuous surveillance and improve effectiveness, so as to provide reference for further intervention.MethodsTargeted surveillance on thyroid surgery patients undergoing class Ⅰ incision operations in a hospital in January June 2013 were performed by medical record review, bedside observation,  dressing change observation  and patient follow up, the surveillance result was compared with that of the same period of 2010. ResultsThere was one case of SSI in January June 2013 and  January June 2010 respectively, SSI rate was 0.20% and 0.18% respectively，there was no significant difference（P=1.000）. In January June 2013, prophylactic perioperative antimicrobial usage rate was 0.20%，which was lower than 27.21% of 2010; the coincident rate of indication for antimicrobial use was 100%, which was higher than 6.67% of 2010, the difference was statistically different(all P＜0.001）. ConclusionTargeted surveillance on SSI is helpful for the rational perioperative use of antimicrobial agents, the reducing of antimicrobial prophylactic use doesn’t lead to the increase of class Ⅰ incision SSI.