某医院普外科Ⅰ类切口手术预防用抗菌药物持续改进研究

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摘要目的为规范医院外科围术期抗菌药物预防性应用与管理,探索合理干预途径。方法选取普外科甲状腺手术、乳腺手术、腹股沟疝修补术3种Ⅰ类切口手术,2011-07至2011-09的出院病例为干预前组(基线调查组),2012-07至2012-09,以及2013-07至2013-09的出院病例为干预后1、2组,对干预前后3组预防使用抗菌药物的合理性进行干预对照研究。结果共调查病历348份,2011-2013年抗菌药物预防使用率依次为96.2%、33.6%、6.9%( P＜ 0. 05)。3种Ⅰ类切口手术3年的抗菌药物预防使用率分别为:甲状腺100%、3.8%、2.9%;腹股沟疝91.8%、55.5%、12.8%;乳腺100%、61.9%、8.7%。结论通过制订干预措施能有效提高医院抗菌药物临床合理应用水平。

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	谢少玲
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关键词 ： Ⅰ类切口手术, 围术期, 抗菌药物, 预防应用, 干预

Abstract：Objective To standardise the antimicrobial prophylaxis(AMP)during perioperative period of surgical operations in this hospital and explore reasonable measures of intervention. Methods Patients who underwent three type I incisions in general surgery: including thyroid, breast and inguinal hermia repair surgery, were recruited. The patients dismissed from July to September of year 2011 were taken as pre-intervention group, and those in year 2012 and 2013 as post-intervention group. The rationaly of antibiolic prophylaxis between pre-intervention group and post-intervention group were compared control study. Results A total of 348 cases were investigated. The utilization rate of antimicrobial prophylaxis from year 2011 to 2013 were 96.2%, 33.6%, 6.9%, respectively. Utilization rates of antimicrobial prophylaxis in the three type I incision surgery during the three years were as follows: 100%, 3.8%, and 2.9% for thyroid surgery; 91.8%, 55.5%, and 12.8% for inguinal hermia repair surgery; 100%, 61.9%, and 8.7% for breast surgery. Conclusions The intervening measures improve effectively the reasonable use of antibiotics in clinic.

Key words： type I incision surgery perioperative period antimicrobics prophylaxis intervention

收稿日期: 2014-03-10

ZTFLH:

R969.4

通讯作者: 刘永刚,E-mail:liuyg1999@163.com E-mail: shirleyxsl@163.com

作者简介: 谢少玲,本科学历,主管药师

引用本文:

谢少玲,张国祥,李芳君,刘永刚. 某医院普外科Ⅰ类切口手术预防用抗菌药物持续改进研究[J]. 武警医学, 2014, 25(11): 1098-1101. XIE Shaoling,ZHANG Guoxiang,LI Fangjun, and LIU Yonggang. Improvement of perioperative antibiotic prophylaxis in this hospital. Med. J. Chin. Peop. Armed Poli. Forc., 2014, 25(11): 1098-1101.

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http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2014/V25/I11/1098

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[7]	徐小刚,李光辉.抗感染药物在外科领域的预防性应用指南[J].中国抗感染化疗杂志,2005,5(3):180-183.
[8]	Togo Y, Tanaka S, Kanematsu A, et al. Antimicrobial prophylaxis to prevent perioperative infection in urological surgery: a multicenter study[J].Infect Chemother,2013,19(6):1093-1101.
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[10]	梅昕,徐莺,刘婧,等.某院Ⅰ类手术切口围术期抗菌药物应用分析[J].武警医学, 2013,24(2):159-162.
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[12]	刘振华,仲华,吕娟丽.围术期应用抗菌药物的合理性及干预前后的对比[J].武警医学,2013,24(11):966-969.
[13]	曾玉琴,朱建勇,柯宗萍,等. 2型糖尿病合并肺部感染病原菌分布及药物敏感性[J]. 华南国防医学杂志,2012,26(4):336-338.
[14]	悦姣星,黄海. 做好医院感染控制工作的理性思考[J]. 华南国防医学杂志,2013,27(7):524-525.