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目的评价我院落实国家卫生和计划生育委员会有关Ⅰ类手术切口抗菌药物预防性应用相关规定的效果。方法将2015年~2016年抗菌药物专项整治后外科Ⅰ类手术切口病例与2012年~2014年的同类病例监测数据进行比较,监测数据包括外科Ⅰ类手术切口预防性应用抗菌药物比例、Ⅰ类手术切口抗菌药物预防性应用时间小于24小时比例、Ⅰ类手术切口术前预防性应用抗菌药物使用时机合格比例、Ⅰ类手术切口抗菌药物预防性应用种类选择合格比例、Ⅰ类手术切口感染率。结果Ⅰ类手术切口抗菌药物预防性应用比例由专项整治前的41.0%降低到26.4%,术后预防使用抗菌药物时间小于24小时比例由64.0%上升到98.0%,抗菌药物品种选择合理比例由专项整治前的90.0%提高到100.0%。使用手术麻醉系统实时监测后,2016年预防性应用抗菌药物使用时机合格比例达到72.0%。专项整治活动后Ⅰ类手术切口感染率有所下降。结论专项整治活动有利于改善Ⅰ类手术切口抗菌药物预防性应用各项指标。Ⅰ类手术切口抗菌药物预防性应用的管理离不开领导的重视、科学的管理方案以及持续的监测与改进。
Objective To evaluate the effect of implementing the relevant provisions of the National Health and Family Planning Commission on the preventive application of class Ⅰ surgical incision antimicrobial agents in our hospital. Methods Surveillance data of Surgical Ⅰ surgical incision after special antimicrobial treatment from 2015 to 2016 were compared with those of similar cases from 2012 to 2014. Surveillance data included the proportion of prophylactic use of antibacterials in Surgical Class Ⅰ surgical incision, Incision antibacterial prophylactic application time of less than 24 hours, type Ⅰ surgical incision preoperative prophylactic use of antibiotics timing percentage, type Ⅰ surgical incision antimicrobial prophylactic application of selected types of qualified percentage, type Ⅰ surgical incision infection rate. Results The proportion of prophylactic use of antibacterials for class I surgical incision was reduced from 41.0% before special treatment to 26.4%, and the proportion of antibacterials prophylactically administered within 24 hours was increased from 64.0% to 98.0%. The reasonable proportion of antibacterials was 90.0% before remediation increased to 100.0%. After the real-time monitoring using the surgical anesthesia system, the qualified rate of prophylactic antimicrobial use in 2016 reached 72.0%. After the special rectification activities, the infection rate of type Ⅰ incision decreased. Conclusion Special rectification activities are conducive to the improvement of class I surgical incision antimicrobial prophylactic use of various indicators. Class I surgical incision antimicrobial prophylactic administration can not be separated from the leadership attention, scientific management programs and continuous monitoring and improvement.