摘要
目的探究老年Ⅰ类切口手术预防使用抗菌药物的合理性,分析预防使用抗菌药物与手术部位感染的关联性。方法回顾性收集2023年度泗县人民医院收治的1002例老年Ⅰ类切口手术出院患者的临床资料,对患者抗菌药物预防性使用率、抗菌药物种类、不合理用药情况和术后切口感染情况进行分析,采用单因素、多因素logistic回归分析法分析预防使用抗菌药物与手术部位感染的关系。结果老年Ⅰ类切口患者抗菌药物预防性使用率为16.97%(170/1002),预防性使用的抗菌药物以头孢呋辛钠(88.89%)为主。预防使用抗菌药物患者的预防用药合理率为17.65%(30/170)。共存在不合理用药247例次,不合理情况以预防用药时机不适宜(38.46%)、预防用药疗程过长(25.51%)为主。老年Ⅰ类切口患者术后手术部位感染率为3.59%(36/1002)。多因素logistic回归分析,结果显示,手术时长≥2 h、异物植入、住院时间≥10 d、未预防使用抗菌药物以及预防使用抗菌药物但不合理均是老年Ⅰ类切口手术患者术后手术部位感染的独立危险因素(P<0.05)。结论老年Ⅰ类切口手术患者预防使用抗菌药物不合理问题主要在于预防用药时机不适宜、预防用药疗程过长。不合理预防使用抗菌药物可能会增加患者手术部位感染风险,临床应提高预防使用抗菌药物的合理率,降低感染风险。
Objective To investigate the rationality of prophylactic use of antimicrobial drugs in the elderly with class I surgical incisions in clinical settings,and analyze the relationship between prophylactic use of antimicrobial drugs and surgical site infection.Methods Clinical data of 1,002 elderly patients with class I surgical incisions who were discharged from Sixian People's Hospital in 2023 were retrospectively collected.The prophylactic use rate of antimicrobial drugs,types of antimicrobial drugs,irrational drug use,and postoperative incision infection were analyzed.Univariate and multivariate logistic regression analyses were used to analyze the relationship between prophylactic use of antimicrobial drugs and surgical site infection.Results The prophylactic use rate of antimicrobial drugs in elderly patients with class I surgical incisions was 16.97%(170∕1002),and cefuroxime sodium was the main antimicrobial drug used(88.89%).The rational rate of prophylactic use of antimicrobial drugs was 17.65%(30∕170),and there were 247 cases of irrational drug use,mainly including inappropriate timing of prophylactic use(38.46%)and long duration of prophylactic use(25.51%).The postoperative incision infection rate in elderly patients with class I surgical incisions was 3.59%(36∕1002).Multivariate logistic regression analysis results showed that duration of surgery,foreign body implantation,length of hospital stay,prophylactic use and rationality of antibiotics were independent risk factors for postoperative incision infection(P<0.05).Conclusion The irrational use of antimicrobial drugs in elderly patients with class I surgical incisions mainly include inappropriate timing of prophylactic use and prolonged duration of prophylactic use.Suboptimal prophylactic use of antimicrobial drugs may increase the risk of surgical site infection in elderly patients.Clinical practice should improve the rational rate of prophylactic use of antimicrobial drugs to reduce the risk of infection.
作者
李姣姣
宋瑞
钟玉婷
LI Jiaojiao;SONG Rui;ZHONG Yuting(Department of Pharmacy,Sixian People's Hospital,Suzhou 234300,Suzhou,China)
出处
《中华保健医学杂志》
2025年第6期1070-1073,共4页
Chinese Journal of Health Care and Medicine
基金
安徽省卫生健康委科研项目(AHWJ2021Hb021)。
关键词
Ⅰ类切口手术
抗菌药物
合理用药
手术部位感染
class I incision surgery
antibacterial drug
rational drug use
surgical site infection
