摘要
目的探讨综合干预对手足外科围手术期抗菌药物的应用效果。方法选取2015年1月-2016年12月医院手足外科收治的进行手术治疗的患者512例,根据围术期是否进行综合干预分为干预组252例及对照组260例,应用自行设计调查表格,统计患者基本信息及抗菌药物使用情况、检查项目及结果等,分析各组抗菌药物预防应用率、抗菌药物种类、给药时间、疗程,比较各组术后手术部位感染情况及抗菌药物使用强度(AUD)。结果干预组Ⅰ类、Ⅱ类切口抗菌药物预防应用率明显低于对照组,差异有统计学意义(P<0.01);干预组第一代头孢菌素类药物、大环内脂类药物应用率明显高于对照组,其余种类抗菌药物应用率均明显低于对照组,差异均有统计学意义(P<0.05);干预组抗菌药物品种选择合理率、给药时间合理率均明显高于对照组,差异有统计学意义(P<0.01);对照组预防性应用抗菌药物的疗程较长,两组术后手术部位感染率差异无统计学意义;干预组AUD为15.88明显低于对照组的45.13。结论综合干预能够提高手足外科围术期抗菌药物应用的合理性。
OBJECTIVE To explore the effect of comprehensive intervention on perioperative use of antibiotics in hand and foot surgery department.METHODS A total of 512 patients who received surgical procedures in the hand and foot surgery department from Jan 2015 to Dec 2016 were enrolled in the study and divided into the intervention group with 252 cases and the control group with 260 cases according to the status of perioperative use of antibiot-ics.The self-designed questionnaires were employed to count up the baseline data,status of use of antibiotics,ex-amination items and results.The rate of prophylactic use of antibiotics,types of antibiotics,drug administration time and courses of the two groups were investigated,and the prevalence rate of postoperative surgical site infec-tion and antimicrobial drug use intensity（AUD）were observed and compared between the two groups of patients. RESULTS The rate of prophylactic use of antibiotics of the patients undergoing the type Ⅰ or Ⅱ incision surgery was significantly lower in the intervention group than in the control group（P〈0.01）.The rate of use of the first generation cephalosporins or macrolides of the intervention group was higher than that of the control group,how-ever,the rate of use of other antibiotics was significantly lower in the intervention group than in the control group （P〈0.05）.The rate of reasonable use of antibiotics and rate of appropriate timing for drug administration was significantly higher in the intervention group than in the control group（P〈0.01）.The treatment course of proph-ylactic antibiotics of the control group was longer than that of the intervention group,there was no significant difference in the incidence of postoperative surgical site infection between the two groups.The AUD of the inter-vention group was 15.88,significantly lower than 45.13 of the control group.CONCLUSION The comprehensive intervention may facilitate the reasonable use of antibiotics in the hand and foot surgery during the perioperative period.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第22期5189-5191,5211,共4页
Chinese Journal of Nosocomiology
基金
宁波市科学技术局基金资助项目(2016A49)
关键词
预防用药
抗菌药物
围术期
综合干预
Antibiotic prophylaxis
Antibiotic
Perioperative period
Comprehensive intervention
