监测-培训-计划干预模式对Ⅰ类切口手术围术期抗菌药物应用的影响研究

发布时间：2018-07-20 18:28

【摘要】：目的研究监测-培训-计划(MTP)干预模式对Ⅰ类切口手术患者围术期抗菌药物应用的影响,为医院感染预防控制工作提供客观依据。方法选取2011年1月-2013年6月及2014年3月-2016年6月医院收治的Ⅰ类切口手术患者作为研究对象,其中抗菌药物应用实施MTP干预前的患者2 516例(干预前组),应用实施MTP干预后的患者2722例(干预后组);对两组患者的临床资料进行比较。结果干预前组患者围术期应用抗菌药物以青霉素类为主,共1065次占38.8%,干预后组以一代头孢为主,共2311次占83.3%;干预前组患者用药总合理率为22.9%,显著低于干预后组80.3%,两组患者比较差异有统计学意义(P0.05);干预前组和干预后组患者的总住院费用和药品费用的差异均无统计学意义,而干预前组患者的抗菌药物费用显著高于干预后组(P0.05)。结论Ⅰ类切口手术患者围术期不合理应用抗菌药物现象仍然普遍存在,采取MTP模式进行干预能够有效提升其应用合理性,降低患者的医疗费用。
[Abstract]:Objective to study the effect of monitoring-training-plan (MTP) intervention on the perioperative use of antimicrobial agents in patients with type I incision operation and to provide an objective basis for the prevention and control of nosocomial infection. Methods Type I incision patients treated in hospitals from January 2011 to June 2013 and from March 2014 to June 2016 were selected as study subjects. The clinical data of 2 516 patients (pre-intervention group) and 2722 patients (post-intervention group) who were treated with antimicrobial agents were compared. Results before intervention, penicillin was mainly used in the perioperative period of patients in the intervention group, accounting for 1065 times (38.8%). After intervention, the primary cephalosporins were used mainly in the intervention group. The total rational rate of drug use in the group before and after intervention was 22.9, which was significantly lower than that in the group after intervention (P 0.05), and the difference between the two groups was statistically significant (P0.05), and there was no significant difference in the total hospitalization cost and the cost of drugs between the two groups before and after the intervention. The cost of antimicrobial agents was significantly higher in the pre-intervention group than in the post-intervention group (P0.05). Conclusion the phenomenon of irrational use of antimicrobial agents in the perioperative period of patients with type I incision operation is still widespread. The intervention of MTP model can effectively enhance the rationality of the application and reduce the medical cost of patients.
【作者单位】：吉林大学第一医院医务部;吉林大学第一医院感控办公室;吉林大学第一医院药品管理部;吉林大学第一医院透析中心;
【基金】：吉林省卫生厅基金资助项目(2011R002)
【分类号】：R978.1

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