外科围手术期抗菌药物使用调查与管理对策

The survey of perioperative antimicrobial administration and management strategies

目的 调查外科手术患者围手术期抗菌药物预防使用现状，进一步推动围手术期预防用药合理化。方法 对931例Ⅰ类与Ⅱ类手术切口患者围手术期抗菌药物使用情况进行回顾性调查。结果 术前30min、术前2～4h及术后预防使用抗菌药物者分别占7．52％，11．82％，80．67％。Ⅰ类切口平均用药时间为5．60d，≤3d者199例（31．34％）；Ⅱ类切口平均用药时间为7．40d，≤3d者71例（23．99％）。围手术期应用第三代头孢菌素者268例，占28．79％。Ⅰ类与Ⅱ类切口发生手术部位感染各1例，手术部位感染率为0．21％。感染发生与预防用药开始时间、用药疗程无相关性（P〉0．05）。结论 围手术期用药方案能达到预防手术部位感染的目的，应积极开展工作推动围手术期预防用药规范化。

Objective To investigate the current status of the perioperative antimicrobial prophylaxis in a hospital and facilitate rational perioperative antimicrobial administration. Methods Perioperative antimicrobial prophylaxis was retrospectively studied in 931 cases with type Ⅰ and Ⅱ incision. Results Prophylactic antimicrobial administration 30 min before operation, 2 ～4 hours before operation and postoperation accounted for 7. 52%, 11.82% and 80. 67% respectively. The mean antimicrobial course was 5. 60 days in type Ⅰ incision with 199 cases （31.34%） no more than 3 days and 7. 40 days in type Ⅱ incision with 71 cases （23.99%） no more than 3 days. 268 cases （28. 79%） received perioperative third generation cephalosporins, one case surgical wound incisional infection occurred in type Ⅰ and type Ⅱ incision respectively, surgical wound incisional infection rate was 0. 21%. The wound infection was not related with initial time of antimicrobial use and the course of prophylactic antimicrobial administration. Conclusion Perioperative antimicrobial application can prevent surgical wound incisional infection, it is essential to standardize perioperative antimicrobial application.