玻璃体切割手术预防性使用抗菌药物干预及效果

Efficacy of intervention in prophylactic antimicrobial use in vitrectomy

摘要:

目的评价目标性监测及综合干预措施对促进玻璃体切割手术围手术期合理使用抗菌药物的效果。方法收集2011年3月—2012年9月某院160例行玻璃体切割手术患者资料，分为干预前组（2011年3—12月间80例手术患者，未干预临床医生预防使用抗菌药物）和干预后组（2012年1—9月间80例手术患者，实施目标性监测综合干预措施）。比较两组患者术后感染率及预防使用抗菌药物情况、费用等。结果术后两组手术切口均无感染。干预后组抗菌药物的平均使用时间为（1.81±1.52）d，显著短于干预前组的（4.02±1.67）d（P＜0.01）；围手术期预防用药率和术后用药时间＞48 h的比率，干预前组分别为100.00%（80/80）、82.50%（66/80），显著高于干预后组的28.75%（23/80）和18.75%（3/16）（均P＜0.05）。干预后组抗菌药物费用为（151.47±6.64）元、药品总费用为（922.56±8.46）元、住院总费用为（8 842.43±8.76）元，均明显低于干预前组各项费用［分别为（507.96±7.67）元、（1 444.63±11.65）元及（9 891.92±10.93）元］（均P＜0.01）。结论目标性监测及综合干预措施能有效促进玻璃体切割手术围手术期抗菌药物的合理使用,降低患者医疗费用。

关键词:

玻璃体切割手术; 手术部位感染; 抗菌药物; 医院感染; 合理用药

Abstract:

ObjectiveTo evaluate the efficacy of targeted monitor and comprehensive intervention measures for promoting rational use of perioperative antimicrobial agents in vitrectomy.MethodsClinical data of 160 patients receiving vitrectomy between March 2011 and September 2012 were collected, patients were divided into preintervention group(80 cases receiving vitrectomy between March and December 2011, antimicrobial use was not intervened) and postintervention group (80 cases receiving vitrectomy between January and September 2012, antimicrobial use was intervened). The postoperative infection rates, antimicrobial prophylaxis,and expense and so on between two groups were compared.ResultsThere was no surgical site infection in both groups. The average duration of antimicrobial use in postintervention group was significantly shorter than that of preintervention group(［1.81±1.52］ d vs ［4.02±1.67］ d, P＜0.01）;the rate of perioperative prophylactic antimicrobial use and duration of postoperative antimicrobial use＞48 h in preintervention group were both significantly higher than those of postintervention group (100.00%［80/80］ vs 28.75%［23/80］; 82.50%［66/80］ vs 18.75%［3/16］; both P＜0.05）;the cost of antimicrobial drugs,total drug cost, and total hospitalization cost in postintervention group was significantly lower than those of preintervention group (［151.47±6.64］ vs ［507.96±7.67］;［922.56±8.46］ vs ［1 444.63±11.65］;［8 842.43±8.76］ vs ［9 891.92±10.93］）yuan (P＜0.01），ConclusionTargeted monitor and comprehensive intervention measures can promote the rational perioperative antimicrobial use in vitrectomy and reduce the medical cost of patients.

Key words:

vitrectomy operation;surgical site infection; antimicrobial agent; healthcareassociated infection; rational drug use