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目的:评价实施干预措施规范经皮冠状动脉介入术(PCI术)、心脏起搏器植入术及先天性心脏病封堵术等心脏介入术围手术期预防用抗菌药物的效果。方法:采用回顾性研究方法,收集实施干预措施前行手术的出院病历56例为干预前组;实施干预措施后的出院病历152例为干预组,并分成两个阶段进行连续干预。比较两组围手术期预防用抗菌药物的合理性。结果:通过两个阶段的干预,预防用药比例显著降低;无指征预防性使用抗菌药物比例由干预前85%下降至8.33%;用药频次由干预前1.07次/例分别下降至0.075次/例和0.17次/例;联合用药比例由29.41%下降至0。在选用药物、疗程及药物用法用量等方面也有不同程度的进步。结论:干预措施对促进围手术期抗菌药物合理应用具有一定的可行性及有效性。但在某些方面仍存在不合理用药的现象。
OBJECTIVE: To evaluate the effect of interventions on the perioperative prophylactic use of antimicrobial agents such as percutaneous coronary intervention (PCI), cardiac pacemaker implantation and congenital heart disease closure. Methods: A retrospective study was conducted to collect 56 cases of discharged medical records prior to the implementation of interventions before intervention. 152 cases of discharged medical records after intervention were treated as intervention group and were divided into two stages for continuous intervention. The rationality of antibiotics for preventing perioperative period in the two groups was compared. Results: The proportion of prophylaxis was significantly reduced by intervention in two stages. The proportion of prophylactic use of antibiotics without any indication decreased from 85% before intervention to 8.33%. The frequency of medication decreased from 1.07 times before intervention to 0.075 times per patient And 0.17 times / case; the proportion of combination medication decreased from 29.41% to 0%. In the selection of drugs, medication and medication usage and other aspects also have varying degrees of progress. Conclusion: The interventions are feasible and effective in promoting rational use of perioperative antibacterials. However, in some aspects there is still the phenomenon of irrational drug use.