骨科临床路径实施对Ⅰ类切口预防性抗菌药物使用效果剖析.docVIP

骨科临床路径实施对Ⅰ类切口预防性抗菌药物使用效果剖析 　　摘 要 目的：探讨骨科临床路径实施对Ⅰ类切口手术预防性抗菌药物使用的影响，为临床Ⅰ类切口手术预防性抗菌药物的使用和管理提供依据。方法：以原卫生部制定的骨科临床路径为基础，结合医院自身的实际情况设计相应临床路径，回顾性调查分析实施临床路径前后患者抗菌药物使用情况。结果：实施临床路径后Ⅰ类切口手术预防性抗菌药物使用的比例从76.49%降低到62.72%，术后感染率没有明显区别，分别为1.04%和0.96%。临床路径组手术后平均用药时间从2.5 d减少到1.1 d。结论：临床路径能够规范Ⅰ类切口预防性抗菌药物的使用，对促进安全合理使用Ⅰ类切口预防性抗菌药物起到促进作用。 　　关键词抗菌药物骨科临床路径 　　中图分类号：R969.3; R978文献标识码：B文章编号：1006-1533(2014)13-0031-03 　　Effect of the implementation of clinical department of orthopedics path (CP) on the application of prophylactic antimicrobial agents in the first-class incision operation 　　HUA Sunying 　　（Deans Office, Jiading District Central Hospital, Shanghai, Shanghai 201800, China） 　　ABSTRACT Objective: To probe the influence of the implementation of clinical department of orthopedics path (CP) on the preventive application of antibiotic in the first-class incision operation so as to provide a basis for the use and management of prophylactic antimicrobial agents in the first-class clinical incision operation. Methods: The use of antibacterial agents was retrospectively investigated and analyzed before and after the implementation of CP by designing corresponding clinical path based on the CP drawn up by the Ministry of Health and the actual situation of our hospital. Results: After implementing the clinical pathway, the ratio of the application of prophylactic antimicrobial agents in the first-class incision operation was significantly reduced from 76.49% to 62.72% (P0.05), and there was no significant difference in the rates of postoperative infection, which were 1.04% and 0.96%, respectively. The average medication time was significantly decreased from 2.5 days to 1.1 days (P0.05). Conclusion: The clinical pathway can regulate the preventive application of antibiotic in the first-class incision operation and promote the rational and safe use of prophylactic antibiotics in the first-class incision operation. 　　KEY WORDSdepartment of orthopedics clinical path; prophylactic antibiotics;