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目的分析抗菌药物专项整治活动对我院子宫手术围手术期抗菌药物应用的影响。方法 2011年1月1日至6月30日前为抗菌药物整治活动前,7月1日至12月31日为整治活动后。回顾性分析2011年在卫生部抗菌药物专项整治活动前后我院开腹子宫全切手术病例围手术期抗菌药物应用情况的差异。结果整治活动前后均无感染病例发生;达标的指标为住院患者抗菌药物使用强度(整治前为58.03 DDD,整治后为28.81 DDD),未达标但有好转的指标为子宫手术住院患者预防使用抗菌药物术前0.5~2 h内给药百分率(59.7%vs.22.2%,掊2=23.987,P﹤0.05)和Ⅱ类切口手术患者预防使用抗菌药物时间≤48 h(77.6%vs.1.0%,Fisher=107.9,P﹤0.05),无变化的指标为住院患者抗菌药物使用率,均为100%。这一指标尚未细化到按照病种进行评价的程度,有待医务工作者和医政管理者在今后的工作实践中继续研究摸索。结论规范应用抗菌药物在我院取得了一定的效果,有些指标尚未达到要求的控制水平,持续进行此项工作任重道远,抗菌药物使用率应制定针对病种的细化指标。
Objective To analyze the influence of antibacterials special rectification on the application of perioperative antibacterials in uterus surgery in our hospital. Methods January 1, 2011 to June 30 before the antimicrobial remediation activities before July 1 to December 31 after remediation activities. The retrospective analysis of the application of antibiotics in perioperative period in our hospital before and after the special rectification activities of antibacterials by the Ministry of Health in 2011 was retrospectively analyzed. Results There were no cases of infection before and after rehabilitative activities; the index of compliance was the intensity of antibacterial use in hospitalized patients (58.03 DDD before rehab and 28.81 DDD after rehabilitating); the indicators that did not reach the standard but improved were the prophylactic use of antibacterial drugs Preoperative 0.5 ~ 2 h administration rate (59.7% vs.22.2%, 掊 2 = 23.987, P <0.05), and class Ⅱ incision surgery to prevent the use of antibacterials time ≤ 48 h (77.6% vs.1.0%, Fisher = 107.9, P <0.05), no change in the indicators for the use of antibiotics inpatients, were 100%. This indicator has not been refined to the degree of evaluation according to the disease, waiting for medical workers and medical administrators in the future work practices continue to explore. Conclusion The standard application of antimicrobial agents has achieved some results in our hospital. Some of the indicators have not reached the required level of control. There is still a long way to go to carry out this work. The utilization rate of antimicrobial agents should be refined for the disease type.