开颅肿瘤切除术患者预防性使用抗菌药物的干预效果
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覃金爱

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R739.91R969.3

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广西壮族自治区卫生厅课题(桂卫Z2013101)


Intervention effect of antimicrobial prophylaxis in patients undergoing craniotomy for tumor resection
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    摘要:

    目的探讨多部门联合干预规范神经外科开颅肿瘤切除术预防性使用抗菌药物的效果。方法通过规范手术前消毒和手术操作,以及抗菌药物使用培训教育、开展品管圈活动和定期检查反馈方式,观察某院开颅肿瘤切除术预防性使用抗菌药物的改进效果。 结果2013、2014年调查的病例手术部位感染发病率分别为7.66%(17/222)和6.80%(27/397),两组比较,差异无统计学意义(χ2=0.158,P>0.05)。手术病例预防性使用抗菌药物:其中头孢呋辛495例,头孢唑林103例,头孢硫咪9例,克林霉素8例,头孢噻肟4例,用药品种比较合理。2014年手术中必要的抗菌药物追加落实率为95.02%,高于2013年的87.66%,两组比较,差异有统计学意义(χ2=7.969,P<0.05)。2014年预防性使用抗菌药物疗程>48 h的患者占30.73%,低于2013年的 57.66%,差异有统计学意义(χ2=42.88,P<0.05)。结论规范手术前消毒和手术操作,开展教育培训、品管圈活动和检查反馈等多种干预措施,可以促进神经外科开颅肿瘤切除术抗菌药物的规范使用。

    Abstract:

    ObjectiveTo evaluate the effect of multidisciplinary intervention on antimicrobial prophylaxis in neurosurgical patients undergoing craniotomy for tumor resection.MethodsBy standardizing preoperative disinfection and surgical procedures, training and education of antimicrobial use, conducting quality control activities, and performing periodic feedback of supervised results, efficacy of improvement of antimicrobial prophylaxis in neurosurgical patients undergoing craniotomy for tumor resection in a hospital was observed.ResultsIn 2013 and 2014, incidences of surgical site infection(SSI) were 7.66%(17/222)and 6.80%(27/397) respectively,there was no significant difference between two groups(χ2 =0.158,P>0.05). Prophylactic use of antimicrobial agents in surgical patients were as follows: cefuroxime(n=495), cefazolin(n=103), cefathiamidine(n=9), clindamycin(n=8), and cefotaxime(n=4), types of used antimicrobial agents were rational. In 2014, the implementation rate of necessary intraoperative antimicrobial adding was 95.02%, which was higher than 87.66% in 2013(χ2=7.969,P<0.05), 30.73% of patients received antimicrobial prophylaxis for>48 hours, which was lower than 57.66% in 2013, difference was significant(χ2=42.88,P<0.05).ConclusionMultiintervention measures, including standard preoperative disinfection and surgical procedures, education and training, quality control circle, and feedback of supervised results can improve standard antimicrobial prophylaxis in neurosurgical patients undergoing craniotomy for tumor resection.

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覃金爱,张影华,李兰兰,等.开颅肿瘤切除术患者预防性使用抗菌药物的干预效果[J]. 中国感染控制杂志,2017,16(4):363-365. DOI:10.3969/j. issn.1671-9638.2017.04.018.
QIN Jinai, ZHANG Yinghua, LI Lanlan, et al. Intervention effect of antimicrobial prophylaxis in patients undergoing craniotomy for tumor resection[J]. Chin J Infect Control, 2017,16(4):363-365. DOI:10.3969/j. issn.1671-9638.2017.04.018.

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  • 收稿日期:2016-09-09
  • 最后修改日期:2016-11-23
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  • 在线发布日期: 2017-04-28
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