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目的探讨甲状腺手术、内固定拆除术和乳腺手术等3种Ⅰ类切口围手术期预防使用抗菌药物的合理性,以期提高临床上合理使用抗菌药物水平。方法回顾性分析2011年1月-2013年1月的甲状腺手术、内固定拆除术和乳腺手术等3种Ⅰ类切口手术的117例患者,其中2011年1-12月为对照组,2012年1月-2013年1月采用监测-培训-计划(MTP)模式进行干预,观察干预前后抗菌药物使用合理性。结果干预后抗菌药物使用率明显下降,不合理使用抗菌药物明显改善;平均药费和抗菌药费由干预前的1 853.24、1 123.9元降至干预后的1 492.5、54.53元。结论采用MTP模式干预抗菌药物的预防使用是行之有效的,能显著地降低预防性抗菌药物使用率,提高合理应用抗菌药物水平,降低医疗费用,促进医疗安全。
Objective To investigate the rationality of perioperative prophylaxis with antimicrobial agents in three kinds of incisions, such as thyroid surgery, internal fixation removal and breast surgery, in order to improve the rational use of antimicrobial agents clinically. Methods A retrospective analysis was performed on 117 patients with type Ⅰ Ⅰ incision, including thyroid surgery, internal fixation removal and breast surgery from January 2011 to January 2013, of which 1 January 2011 was the control group and 1 January 2012 Month-January 2013 Intervention was conducted using the monitoring-training-planning (MTP) model to observe the rational use of antimicrobial agents before and after the intervention. Results After the intervention, the usage of antibacterials decreased significantly, and the irrational use of antibacterials significantly improved. The average cost of antibacterial drugs decreased from RMB 1 853.24 and RMB 1 123.9 before the intervention to RMB 1 492.5 and RMB 54.53 respectively. Conclusion The use of MTP model to prevent the use of antimicrobial agents is effective, can significantly reduce the use of preventive antimicrobial agents, improve the rational use of antimicrobial agents, reduce medical costs and promote medical safety.