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目的:评价小儿腹股沟疝修补术围手术期预防用药的干预管理效果,探索适合小儿腹外疝修补术预防用药的干预模式。方法:选取2011年手术病例作为非干预组,回顾性分析围手术期预防用药存在的主要问题,将2012-2015年手术病例作为干预组,对围手术期抗菌药物预防使用率、平均预防用药天数、平均预防用药费用、平均住院天数、手术部位感染率等指标进行重点监控和干预管理。结果:经过4年干预管理,小儿腹股沟疝修补术围手术期抗菌药物预防使用率由干预前的100%下降为干预后的0%;平均预防用药天数由干预前的≤1 d下降为干预后的0d;平均预防用药费用由干预前的37.66元下降为干预后的0元;平均住院天数均≤1 d;干预前后手术部位感染率无显著性差异(P>0.05)。结论:小儿腹股沟疝修补术围手术期预防用药干预措施具有可行性和有效性,对安全、有效、经济、合理地使用抗菌药物起到了积极的促进作用,为医院设计单病种临床路径和降低单病种费用提供了参考依据,也为进一步规范其它清洁手术预防用药提供了可操作性的干预模式。
OBJECTIVE: To evaluate the intervention management of perioperative prophylaxis in children with inguinal hernia repair and to explore an intervention model suitable for prophylactic use of pediatric external hernia repair. Methods: The surgical cases of 2011 were selected as the non-intervention group. The main problems of perioperative prophylaxis were retrospectively analyzed. Surgical cases from 2012 to 2015 were taken as the intervention group. The preventive and therapeutic rates of antibiotics, , The average preventive medication costs, the average length of stay in hospital, surgical site infection rate and other indicators of key monitoring and intervention management. Results: After 4 years’ intervention management, the prophylactic use rate of perioperative antibiotics in children with inguinal hernia repair decreased from 100% before intervention to 0% after intervention. The average number of preventive medication decreased from ≤1 d before intervention to intervention The average cost of preventive medication decreased from 37.66 yuan before intervention to 0 yuan after intervention; the average length of hospital stay was less than or equal to 1 day; there was no significant difference in infection rate between before and after intervention (P> 0.05). CONCLUSION: Perioperative prophylactic interventions for inguinal hernia repair in children are feasible and effective. They play an active role in promoting the safe, effective, economical and rational use of antimicrobial agents. They are designed to reduce the clinical pathways of single disease in hospitals Single-disease costs provide a reference basis, but also to further regulate the other clean surgical prophylaxis provides a practical mode of intervention.