CAJ | 학술논문

目的：探讨抗菌药物临床应用专项整治活动综合干预措施对Ⅰ类切口手术预防用药合理应用的成效。方法随机抽取我院2010～2013年Ⅰ类切口手术病历，对干预前后Ⅰ类切口抗菌药物使用率，药物选择，联合用药，术前用药时机和术后持续时间等进行对照分析。结果经持续干预，Ⅰ类切口手术预防用药合理性显著提高。抗菌药物使用率和联合用药分别由干预前的100%和34.44%下降至49.44%和2.25%，术前用药时机和术后持续时间的不合理分别由原来的32.22%和85%均下降到2.22%，抗菌药物的选择由干预前以β-内酰胺类含酶抑制剂和第三代头孢菌素为主，到干预后以第二代头孢菌素预防为主。结论我院Ⅰ类切口手术预防用药趋于合理，干预措施有效可行。但仍存在预防使用率偏高现象，需进一步加强监理力度，促进围术期抗菌药物的合理使用。
목적：탐토항균약물림상응용전항정치활동종합간예조시대Ⅰ류절구수술예방용약합리응용적성효。방법수궤추취아원2010～2013년Ⅰ류절구수술병력，대간예전후Ⅰ류절구항균약물사용솔，약물선택，연합용약，술전용약시궤화술후지속시간등진행대조분석。결과경지속간예，Ⅰ류절구수술예방용약합이성현저제고。항균약물사용솔화연합용약분별유간예전적100%화34.44%하강지49.44%화2.25%，술전용약시궤화술후지속시간적불합리분별유원래적32.22%화85%균하강도2.22%，항균약물적선택유간예전이β-내선알류함매억제제화제삼대두포균소위주，도간예후이제이대두포균소예방위주。결론아원Ⅰ류절구수술예방용약추우합리，간예조시유효가행。단잉존재예방사용솔편고현상，수진일보가강감리력도，촉진위술기항균약물적합리사용。
Objective To investigate the clinical effects of comprehensive intervention measures on rational preventive utilization of antibiotics for type I surgical incision after a special improving campaigns. Methods Medical records of type I surgical incisions from 2010 to 2013 in our hospital were randomly selected. A before and after comparison was performed on the data including utilization rate of antibiotics on type I incision, drug selection, drug combination, drug administration time before surgery and duration time after surgery. Results After the sustained intervention, rational preventive utilization of antibiotics for type I surgical incision was improved significantly. Antimicrobial utilization rate and combination utilization decreased from 100% and 34.44% before the intervention to 49.44% and 2.25%respectively. The irrational rate of drug administration time before operation and duration time after operation decreased from 32.22%and 85%to 2.22%respectively. The selection spectrum of main antibiotics di verted from β-lactam containing enzyme inhibitors and third-generation cephalosporins before intervention to sec ond-generation cephalosporins after intervention. Conclusion The utilization of preventive antibiotics for type I surgical incision in our hospital is rationalized, and the intervention measures are effective and feasible. But the preventive utilization rate is still high. The further measures on the supervision should be adopted to promote the rational utilization of perioperative antimicrobial drugs.