CAJ | 학술논문

目的：探讨抗菌药物规范化管理对Ⅰ、Ⅱ类切口中抗菌药物预防应用情况的影响。方法选取厦门大学附属第一医院实施《抗菌药物临床应用管理办法》和《2013年全国抗菌药物临床应用专项整治活动方案》前临床外科有效手术病例250份和实施后临床外科有效手术病例200份，病例中Ⅰ类切口手术选取疝修补手术和甲状腺手术，Ⅱ类切口手术选取剖宫产手术，收集患者手术以及抗菌药物用药等基本情况，统计比较抗菌药物规范化管理和整顿前后患者术前抗菌药物使用率、手术期间抗菌药物给药时间选择、术后应用抗菌药物时间变化以及联合用药情况。结果本院经整顿后，符合抗菌药物应用规范和标准的有：甲状腺手术抗菌药物使用率为0和术后停药时间在1d内；3种手术（疝修补手术、甲状腺手术、剖宫产手术）均无联合用药情况。整顿后抗菌药物应用改善明显但仍然没有达到抗菌药物应用规范和标准的有：疝修补手术患者抗菌药物使用率为62.00％，高于抗菌药物应用规范中30％的标准；疝修补手术患者术后停用抗菌药物时间为（1.01±0.15）d，超过1 d的标准；孕妇剖宫产手术术后停药时间为（2.02±0.25） d，超过2 d的标准。结论医院加强抗菌药物应用管理和加强抗菌药物应用规范化的整治，可以促进外科Ⅰ、Ⅱ类切口中抗菌药物应用的规范化，提高医院抗菌药物应用管理质量。
목적：탐토항균약물규범화관리대Ⅰ、Ⅱ류절구중항균약물예방응용정황적영향。방법선취하문대학부속제일의원실시《항균약물림상응용관리판법》화《2013년전국항균약물림상응용전항정치활동방안》전림상외과유효수술병례250빈화실시후림상외과유효수술병례200빈，병례중Ⅰ류절구수술선취산수보수술화갑상선수술，Ⅱ류절구수술선취부궁산수술，수집환자수술이급항균약물용약등기본정황，통계비교항균약물규범화관리화정돈전후환자술전항균약물사용솔、수술기간항균약물급약시간선택、술후응용항균약물시간변화이급연합용약정황。결과본원경정돈후，부합항균약물응용규범화표준적유：갑상선수술항균약물사용솔위0화술후정약시간재1d내；3충수술（산수보수술、갑상선수술、부궁산수술）균무연합용약정황。정돈후항균약물응용개선명현단잉연몰유체도항균약물응용규범화표준적유：산수보수술환자항균약물사용솔위62.00％，고우항균약물응용규범중30％적표준；산수보수술환자술후정용항균약물시간위（1.01±0.15）d，초과1 d적표준；잉부부궁산수술술후정약시간위（2.02±0.25） d，초과2 d적표준。결론의원가강항균약물응용관리화가강항균약물응용규범화적정치，가이촉진외과Ⅰ、Ⅱ류절구중항균약물응용적규범화，제고의원항균약물응용관리질량。
Objective To investigate effect of antibiotic standardized management on prophylactic application of antimicrobial agents in type I andⅡ incision.Methods The hospital implemented the rule of Clinical Use of Antibiotics Management Approach and 2013 National Clinical Use of Antibiotics Special Rectification Program of Activities, 200 clinical surgery effective surgical cases before implementation and 250 clinical surgical effective surgical cases after implementation were selected.The thyroid surgery and hernia repair surgery were chosen as type I incision, and cesarean section were chosen as type Ⅱ incision.The basic data of surgery classification and antibacterials use were collected, then the antibiotics utilization ratio, the timing of administration of antibiotics, postoperative use of antibiotics time and combination therapy were compared between pre-implementation and post-implementation.Results The condition in accordance with applicable standards of antibiotics post-implementation: the antibiotics utilization ratio of thyroid surgery was 0 and post-operative stopping time was within one day.There was no combination therapy of three types surgery ( thyroid surgery, hernia repair surgery and cesarean section).The application of antimicrobial agents improved significantly but did not reach criteria:antibiotics utilization ratio of hernia repair surgery was 62.00%, which was higher than the criterion of 30% in antibiotic standardized management.Withdrawal time of antimicrobial agents post-operation in hernia repair surgery was (1.01 ±0.15)d which was above the standard of 1d and in cesarean section was (2.02 ±0.25)d which was above the standard of 2d.Conclusion The hospital strengthens management and standardizd regulation of antimicrobial drugs could facilitate standardization in type I and Ⅱ incision, and improve the quality of hospital medication administration of antibiotics.