万古霉素预防手术部位感染的临床应用分析

Applicational Analysis of Vancomycin for Prevention of Operative Site Infection

目的:了解我院外科手术预防性应用万古霉素(包括去甲万古霉素)的情况。方法:抽查2 0 0 2年1月1日～2 0 0 2年1 2月31日两个外科科室应用万古霉素的病例1 5 1份,填写调查表,并对数据进行统计分析。结果:被调查科室的万古霉素总使用率分别为6 0 . 74 %和36 .93%。手术预防性使用万古霉素的用药率为83 . 5 %;1 4 . 4 %病例用药时机为术前≤2小时,8 . 3%病例在术后次日用药,其他病例为手术当日用药;用药持续时间大于术后7天的病例,占总预防性用药病例的34 . 8%。预防用药出现的偏差是选药不当、用药时机不当和持续用药时间过长。结论:我院清洁切口手术预防性使用抗生素尚存在一些问题,需加强规范化使用的管理。

OBJECTIVE:To investigate prophylactic use of vancomycin (including norvancomycin) in operation in surgical departments. METHODS: To randomly check 151 cases which used vancomycin in two surgical departments from Jan.1. to Dec.31. in 2002, filling in questionnaire and analyzing the data. RESULTS: The total usage rate of vancomycin in two surgical departments was 60.74% and 36.93%, respectively. The rate of prophylactic use of vancomycin in operation was 83.5% ; 14.4% cases began to use the drug ≤2 hours before operation, 8.3% cases next day after operation, rest of cases in just operation day. The cases that the duration of drug use exceeded 7 days after operation took up 34.8% of the total cases taking prophylactic use of vancomycin. The lapsus induced by prophylactic use of the drug was improperly select drugs and time of drug use, as well as overlong duration. CONCLUSION: Prophylactic use of antibiotics in operation in our hospital has still existed some problems, needing to strengthen standardized management.