摘要
目的探讨医院骨科Ⅰ类切口抗菌药物使用现状及影响因素。方法抽取医院2016年7月至2017年6月骨科Ⅰ类手术切口患者病历360份,汇总抗菌药物使用情况并分析其影响因素,比较不同使用情况患者间术后感染率和住院时间。结果 360例骨科Ⅰ类切口手术患者中,350例使用抗菌药物,使用率为97. 22%,其中头孢类129例(36. 86%),喹诺酮类115例(32. 86%),β-内酰胺酶抑制剂65例(18. 57%),青霉素类41例(11. 71%),合理使用率46. 00%(161/350)。Logistic多因素分析结果显示,手术并发症是危险因素(OR=2. 305,P <0. 05),加强合理用药的培训和护理方式是保护因素(OR=0. 404,0. 511,P <0. 05)。合理使用抗菌药物组术后感染发生率和住院时间均显著低于不合理使用组(P <0. 005)。结论骨科Ⅰ类切口手术患者抗菌药物合理使用率偏低,可能与术后并发症有关。强化对医护人员抗生素合理应用的规范化培训,改善护理方式有助于提高抗菌药合理使用率,减少术后感染,促进患者早期康复。
Objective To investigate the current situation of the use of antibacterials for type I incision in the Department of Orthopaedics and its influencing factors. Methods Totally 360 medical records of patients with type I incision discharged from the Department of Orthopedics in our hospital from July 2016 to June 2017 were selected, the usage of antibacterials was summarized, and the influencing factors were analyzed, the postoperative infection rates and hospitalization time among patients with difl^rent usage conditions were compared. Results There were 350 patients who were used antibacterials in the 360 patients with type I incision in the Depart- ment of Orthopedics, the utilization rate was 97.22%.The cephalosporins were 129 cases（36. 86% ）, the quinolones were 115 cases （32.86%）, the [3-lactamase inhibitors were 65 cases（18.57% ）, the penicillins were 41 cases（ll.71% ）, the reasonable use rate was 46. 00% （161/350）.The Logistic multivariate analysis showed that surgical complication was a high risk factor（OR =2. 305, P 〈 0.05）, strengthening the standardized training on rational drug use and nursing were the protective factors（ OR =0. 404, 0. 511, P 〈 0.05）. The incidence rate of postoperative infection and hospitalization time in the rational use of antibacterials group were significantly lower than those that of irrational use group（ P 〈 0.05）. Conclusion Low rational use of antibacterials in patients with type I incision in the Department of Orthopedics may be related to post- operative complications. Strengthening the standardized training of rational use of antibacterials for medical staffs and improving the nursing methods are helpful to improve the rational use rate of antibacterials, reduce postoperative infection and promote early rehabilitation of patients.
作者
严江
Yan Jiang(General Hospital of Hubei Jianghan Oilfield,Qianjiang,Hubei,China 433124)
出处
《中国药业》
CAS
2018年第21期89-91,共3页
China Pharmaceuticals
基金
湖北江汉油田总医院院级课题[2018-15]
关键词
骨科手术
Ⅰ类切口
抗菌药物
合理用药
药房管理
orthopaedic surgery
type I incision
antihacterials
rational drug use
pharmacy management
