摘要
目的分析骨科I类切口手术中内固定植入术和术后内固定装置取出术的抗菌药物预防使用情况,分析不合理的原因,为临床合理用药提供依据。方法该次研究一共选择了2018年1—12月和2019年1—12月期间收治的骨科内固定相关I类切口手术患者,2018年患者为1050例,2019年患者为1120例。调查分析抗菌药物预防使用情况。结果与2018年(57.62%、57.85%、3.7 d、4.30%、97.02%)相比,2019年骨科内固定相关I类切口手术患者抗菌药物预防使用率明显降低,术前0.5~1 h给药率有所提高,平均预防使用天数不变,预防疗程≤24 h率仍较低,品种合理率略有升高(49.11%、65.27%、3.7 d、5.45%、98.55%)(χ^2=15.772、0.404、12.252)。2018年的给药时机不合理中术前>1 h给药率,术前<0.5 h给药率,术中给药率,术后给药率(8.63%、66.67%、13.73%、10.98%)等围术期术前给药时机不合理比例要高于2019年(7.85%、62.83%、6.81%、7.85%)(χ^2=0.085、4.504、5.444、1.226)。2018年的三代头孢、头霉素类、口服抗菌药物等围术期预防使用抗菌药物品种不合理数量(n=18)高于2019年(n=8)(χ^2=3.291、0.462、2.497,P=0.070、0.496、0.114)。结论通过制定指标,每月达标情况与绩效挂钩,每月通报I类切口手术围术期抗菌药物预防使用情况等措施,可以降低骨科内固定相关I类切口手术患者抗菌药物预防使用率,提高围术期给药时机合理率。
Objective To analyze the preventive use of antibacterial drugs in internal fixation implantation and postoperative removal of internal fixation devices in orthopedic class I incision surgery,analyze the unreasonable reasons,and provide a basis for clinical rational use of drugs.Methods This study selected a total of orthopedic internal fixation-related type I incision surgery patients who were admitted between January to December 2018 and January to December 2019.There were 1050 patients in 2018 and 1120 patients in 2019.Investigate and analyze the preventive use of antibiotics.Results Compared with 2018(57.62%,57.85%,3.7 d,4.30%,97.02%),the preventive use rate of antimicrobial drugs in patients with type I incision surgery related to orthopedic internal fixation in 2019 was significantly reduced,0.5~1 h dosing rate had increased,the average preventive use days remained unchanged,the rate of preventive treatment≤24 h was still low,and the reasonable rate of variety remains unchange slightly elevated(49.11%,65.27%,3.7 d,5.45%,98.55%)(χ^2=15.772,0.404,12.252).The timing of administration in 2018 was unreasonable,the rate of the preoperative administration was>1 h,the preoperative administration was<0.5 h,the intraoperative administration,the postoperative administration(8.63%,66.67%,13.73%,10.98%)and other perioperative irrational timing of preoperative administration was higher than those of 2019(7.85%,62.83%,6.81%,7.85%)(χ^2=0.085,4.504,5.444,1.226).In 2018,the unreasonable number of perioperative preventive use of antibacterial drugs such as third-generation cephalosporins,cephalosporins,and oral antibacterials(n=18)was higher than that in 2019(n=8)(χ^2=3.291,0.462,2.497,P=0.070,0.496,0.114). Conclusion By establishing indicators, linking monthly compliance with performance, monthly reporting of the preventive use of antimicrobial drugs during the perioperative period of class I incision surgery, etc., the preventive use rate of antimicrobial drugs in patients with class I incision surgery related to orthop
作者
沈娟
SHEN Juan(Department of Pharmacy,Haimen People's Hospital,Haimen,Jiangsu Province,226100 China)
出处
《系统医学》
2020年第20期144-146,共3页
Systems Medicine
关键词
骨科I类切口手术
抗菌药物
预防
干预效果
Orthopedic type I incision surgery
Antibacterial drugs
Prevention
Intervention effect
