摘要
目的探讨综合干预对基层医院清洁手术围术期抗菌药物使用情况的影响。方法随机抽取山东省临沂市沂南县人民医院2016年7~12月中3种最典型的Ⅰ类切口手术病历210份(对照组)。另随机抽取2017年7~12月中采用综合干预后的3种最典型的Ⅰ类切口手术病历210份(干预组)。对照组围术期常规预防性使用抗生素,干预组在对照组基础上给予综合干预。比较两组预防用药使用大体情况、预防使用抗菌药物的用药时机选择、预防使用抗菌药物种类以及术后不良反应发生情况等内容。结果干预组抗菌药物预防用药使用率低于对照组(P<0.01)。干预组合理用药情况优于对照组(P<0.05)。对照组涉及四类9个品种抗菌药物,其中头孢菌素123例(67.2%)、β-内酰胺/β-内酰胺酶抑制剂37例(20.2%)、青霉素类18例(9.8%)、单环β-内酰胺类5例(2.8%)。干预组涉及三类9个品种,其中头孢菌素的使用比例较对照组显著增加(92.0%),β-内酰胺/β-内酰胺酶抑制剂和青霉素类使用均有显著下降(4.0%,4.0%),已不再使用单环β-内酰胺类(即氨曲南)。所有病例均为恢复痊愈,且均无继发院内感染及与用药相关的严重不良反应。结论经过综合干预,我院抗菌药物的使用比例降低明显,且预防时机转向合理。但仍存在部分问题,仍需不断改进,加强干预力度和监管强度,使基层医院清洁手术围术期预防用药更趋于合理化,规范化。
Objective To explore the influence of comprehensive intervention in antibiotic application during perioperative period of clean operation of primary hospitals.Methods A total of 210 sample of the three typical type Ⅰ incisions in Yi＇nan People＇s Hospital of Linyi City （for short ＂our hospital＂） from July to December 2016 was selected as control group.In addition,total of 210 sample of the three most typical type Ⅰ incisions from our hospital from July to December 2017 were selected as intervention group.The control group was given to routine perioperative prophylactic use of antibiotics,the intervention group was given to comprehensive intervention based on the control group.The general situation of prophylaxis drugs use,timing of prophylaxis antimicrobial drugs use,type of antimicrobial drugs use and the postoperative adverse reactions were compared.Results The utilization rate of antibacterial drugs in the intervention group was lower than that in the control group （P 〈 0.01）.The rational use of the intervention group was superior to the control group （P 〈 0.05）.There were 4 classes of 9 kinds of antibiotics in the control group,including Cephalosporins of 123 cases （67.2%）,beta lactam/beta lactamase inhibitor of 37 cases （20.2%）,the Penicillin of 18 cases （9.8%）,mono cyclic beta lactam of 5 cases （2.8%）.There were involved 3 class of 9 kinds of antibiotics in the intervention group,in which,the use of cephalosporins rate increased significantly compared with the control group （92.0%）,the use of beta lactam/beta lactamase inhibitor and penicillin class had declined significantly （4.0%,4.0%）,monocyclic beta lactam type （i.e.,ammonia QuNa） was no use.The cases were all recovered after intervention,and there were no secondary infections and severe adverse reactions associated with the drug.Conclusion Through comprehensive intervention,the use of antibacterial drugs in our hospital has reduced obviously,and the timing of prevention is reasonable.But there are still parts of the problem,it still needs to continue to strengthen the intensity of intervention and regulation,to make antibiotic application during perioperative period of clean operation of primary hospitals tend to be more rationalization and standardization.
作者
夏荣芬
XIA Rongfen(Pharmacy Department, Yi＇nan People＇s Hospital of Linyi City, Shandong Province, Yi＇nan 276300, Chin)
出处
《中国医药导报》
CAS
2018年第14期116-119,共4页
China Medical Herald
关键词
综合干预
围术期抗菌药物使用
清洁手术
基层医院
Comprehensive intervention
Perioperative antibiotic use
Clean surgery
Primary hospitals
