[關(guān)鍵詞]
[摘要]
目的 分析威海衛(wèi)人民醫(yī)院干預(yù)前后普外科圍手術(shù)期預(yù)防用抗菌藥物的使用情況,為合理使用抗菌藥物提供依據(jù)。方法 選取威海衛(wèi)人民醫(yī)院普外科2015年3~5月(干預(yù)前)與2016年3~5月(干預(yù)后)的圍手術(shù)期病例各122例,比較干預(yù)前后抗菌藥物的用藥指征、用藥療程、藥物選擇、用法用量、無指征換藥和用藥途徑。結(jié)果 干預(yù)后,用藥指征不合理例數(shù)明顯低于干預(yù)前,且無指征用藥多存在于Ⅱ類切口手術(shù);干預(yù)后抗菌藥物應(yīng)用時(shí)間多為24 h之內(nèi),明顯短于干預(yù)前,干預(yù)前后比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);干預(yù)前用藥頭孢菌素類占49%,喹諾酮類占29%,干預(yù)后頭孢菌素類占79%,克林霉素類占13%,干預(yù)后藥物選擇合理性較干預(yù)前明顯改善;干預(yù)前有2例無指征換藥和2例用藥途徑不合理情況,干預(yù)后無此類不合理情況;干預(yù)后患者的住院時(shí)間縮短,感染率降低,費(fèi)用明顯減少(P<0.01)。結(jié)論 積極的干預(yù)普外科圍術(shù)期抗菌藥物預(yù)防用藥,可改善其不合理用藥情況,降低患者術(shù)后感染的發(fā)病率、減少住院時(shí)間和費(fèi)用。
[Key word]
[Abstract]
Objective To analyze the prophylactic use of antibiotics in perioperative prophylactic application of antibiotics in Department of General Surgery of Weihaiwei People's Hospital before and after intervention, and to provide valuable reference for rational use of antibiotics. Methods Perioperative patients (122 cases) in Department of General Surgery of Weihaiwei People's Hospital from March to May 2015 (before intervention) and March to May 2016 (after intervention) were respectively selected, medical indication, medicinal course, drug choice, usage and dosage, no indications of dressing change, and route of administration were compared before and after intervention. Results After intervention, the irrational cases in medical indication were less than those before intervention, and most of them happened toⅡ class incision. After intervention, the application time of most antibiotics was less than 24 h, which was less than that before intervention, and there was significant difference between those before and after intervention (P<0.05). Before intervention, cephalosporins accounted for 49%, and quinolones accounted for 29%, while after intervention, cephalosporins accounted for 79%, and clindamycins accounted for 13%. The rationality of drug choice was improved after intervention. There were 2 cases of patients with no indications of dressing change and 2 cases of patients with unreasonable route of administration before intervention, while there was no unreasonable medication after intervention. There was a dramatically downward trend in patient's treating duration, infection rate, and treatment costs after intervention (P<0.01). Conclusion Active intervention in perioperative prophylactic application of antibiotics in Department of General Surgery can improve the irrational medication, decrease the incidence of postoperative infection, and reduce hospitalization time and cost.
[中圖分類號(hào)]
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