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目的调查骨科3年Ⅰ类切口手术围手术期预防使用抗菌药物情况,了解骨科执行抗菌药物干预措施,为进一步规范骨科抗菌药物使用提供理论依据。方法回顾性调查2010年8月、2011年8月、2012年4月骨科Ⅰ类切口手术232例出院患者抗菌药物使用及切口感染率。结果 2010、2011、2012年抗菌药物预防使用率分别为100.0%、69.7%、70.6%,品种选择合理率分别为15.5%、65.6%、63.3%,用药时机合理率分别为82.8%、88.7%、93.3%,使用疗程合理率分别为1.7%、8.1%、20.0%,切口感染率分别为1.7%、1.1%、0。结论通过加强对围手术期预防用药的管理,在减少预防用药的前提下,骨科3年切口感染率呈下降趋势,但在抗菌药物预防使用率、规范选用抗菌药物、预防用药时间等方面仍未达到卫生部要求,需进一步加强监管和培训力度,促进抗菌药物合理使用。
Objective To investigate the perioperative prevention and treatment of antimicrobial agents in Class Ⅰ incision for 3 years and to understand the interventional measures of antimicrobial agents in orthopedics and provide a theoretical basis for further regulating the use of antimicrobial drugs in orthopedics. Methods Retrospective investigation of antimicrobial use and incision infection rate in 232 patients discharged from orthopedic class Ⅰ incision in August 2010, August 2011 and April 2012 were retrospectively studied. Results The rates of prophylaxis and antibacterial drug use in 2010, 2011 and 2012 were 100.0%, 69.7% and 70.6%, respectively. The reasonable rates of selecting antibacterials were 15.5%, 65.6% and 63.3% respectively. The reasonable rates of taking drugs were 82.8% and 88.7% 93.3% respectively. The reasonable rates of using them were 1.7%, 8.1% and 20.0% respectively, and the incision infection rates were 1.7%, 1.1% and 0 respectively. Conclusions By strengthening the management of perioperative prophylaxis, the infection rate of incision at 3 years of orthopedics shows a downward trend under the premise of reducing prophylaxis, but the rate of preventive use of antimicrobial agents, the standard selection of antimicrobial agents and the time of preventive medication have not yet been achieved To meet the requirements of the Ministry of Health, supervision and training needs to be further strengthened to promote the rational use of antimicrobial agents.