成都市8所医院460例剖宫产手术围手术期预防用抗菌素药物的调查分析

Investigation of the Prophylactic Use of Antibiotics in 460 Cases of Uterine-incision Deliver Patients in Their Perioperation in 8 Hospitals of Chengdu City

目的:了解成都市医院剖宫产手术围手术期预防用抗菌素药物现状,为加强医院管理,促进临床合理应用抗菌药物提供依据。方法:采用分层随机抽样方法抽取成都市8家样本医院,并在样本医院中随机抽取2005年剖宫产手术病例460例,对围手术期预防用抗菌素药物情况进行分析评价。结果:围手术期预防用抗菌素药物存在问题有:①初次给药时机不合适,无在麻醉诱导时初次用药者,且绝大多数为术后初次用药(83.48%);②总的用药时间偏长,>48h者达97.83%;③不合理用药比例8.04%,选择用药的合理性有待提高。结论:应将合理用药纳入医院管理年考评标准和产科医师继续医学教育内容,建立健全临床药师制度,进一步规范临床用药行为。

Objective： To improve the reasonable clinical use and the hospital management on antibiotics usage through investigating the status of the prophylactic use of antibiotics in patients beard the uterine-incision delivery in the general hospitals of Chengdu city. Methods. Totally 460 case history records of patients beard the uterine-incision delivery in 2005 of 8 hospitals were investigated on the prophylactic use of antibiotics sampled by using stratification random sampling method. Results： The defects existed in the prophylactic use of antibiotics as： ① The beginning of using antibiotics absolute majority （83. 48%） was in post-operation, none in anesthesia inductive phase. ② Using period was too long, and 97. 83% of case was prescript antibiotics more than 48 hours. ③ The percentage of improper application of antibiotics was 8. 04%, rationality of prophylactic use of antibiotics need to be improved. Conclusions： Ought to bring the reasonable application of antibiotics into the standards of hospital examination and into the continue education of obstetricians to standardize the application of antibiotics further.