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目的:规范眼科I类切口手术抗菌药物预防使用,探索有效的干预措施,促进眼科抗菌药物临床合理应用。方法:对2011年1月-2013年10月51 110例接受I类切口手术眼科住院患者进行目标监测,对I类切口手术抗菌药物预防使用率、住院患者抗菌药物使用率、医院感染发病率等指标进行统计学分析,以评价干预效果。结果:2011年1月-2013年10月共51 110例眼科I类切口手术患者,抗菌药物预防使用率由2011年的63.90%下降至2012年的25.93%,2013年1-10月份下降到17.81%;住院患者抗菌药物使用率由2011年61.86%下降至2012年25.86%,2013年1-10月份进一步下降到19.41%;在降低眼科I类切口手术抗菌药物使用率的同时,3年间手术部位感染率、医院感染发病率差异无统计学意义。用药及未用药I类切口手术病例院内感染率进行比较,差异无统计学意义。结论:通过多项科学有效的综合干预措施,显著降低了眼科I类切口手术抗菌药物预防使用率,同时不会增加患者医院感染发生的风险。
Objective: To standardize the prevention and treatment of ophthalmic Class I incision surgery antibiotics, to explore effective interventions and to promote the rational clinical application of ophthalmic antibacterial drugs. Methods: From January 2011 to October 2013, 51 110 ophthalmic inpatients undergoing type I incision surgery were enrolled in this study. The preventive and therapeutic use of antibacterials for type I incision surgery, the rate of antibacterials inpatients, the incidence of nosocomial infections and so on Indicators for statistical analysis to assess the effect of intervention. Results: From January 2011 to October 2013, a total of 51 110 patients undergoing ophthalmic class I incision were enrolled in this study. The rate of antimicrobial prophylaxis dropped from 63.90% in 2011 to 25.93% in 2012 and to 17.81 in January-October 2013 %; Inpatient antibacterial drug usage decreased from 61.86% in 2011 to 25.86% in 2012 and further decreased to 19.41% in January-October 2013. In addition to reducing the use of antibacterials in ophthalmic Class I incision surgeries, the surgical site Infection rate, the incidence of nosocomial infection was no significant difference. No difference was found between the nosocomial infection rates of patients with type I incision and no medication. Conclusion: Through a number of scientific and effective comprehensive interventions, the preventive and prophylactic use rate of ophthalmic Class I incision surgeries was significantly reduced without increasing the risk of nosocomial infections in patients.