结肠切除术围手术期抗菌药物预防性使用调查

Survey and analysis of perioperative antibiotic prophylaxis in colon resection

目的了解结肠切除术围手术期抗菌药物使用情况，为抗菌药物的合理应用和管理提供科学依据。方法对本院2000—2003年间行结肠切除术的患者291倒进行回顾性调查，从抗菌药物的种类、用药频次、联合用药、预防用药的时间和数量、术后用药天数及术后感染等进行调查分析。结果术后医院感染42例，感染例次率14．43％。抗菌药物的预防性用药率为100％，联合用药占89．01％；抗菌药物中应用频率最高的种类是头孢菌素类（占24．05％），其次为口内酰胺类／0内酰胺酶抑制刑（占23．04％）和甲硝唑类（占22．53％）。结论严格按围手术期预防用药原则应用者少，存在抗茼药物滥用和联合用药不当情况。临床医生应合理用药。避免围手术期抗菌药物不合理的预防性使用。

Objective To survey perioperative antibiotic prophylaxis in the colon resection for improving the management and proper clinical utilization. Methods A total of 291 cases with colon resection inpatients from 2000 to 2003, were retrospectively analyzed in respect of kinds, frequency, muhitherapy in combination with other drugs, the situation of administration for prophylaxis such as timing, amount and duration after operation, and the situation of infection after operation. Results The rate of preventive antibiotic utilization was 100%. The rate of nosocomial infection was 14.43% （42 cases）. Cephalosporins were the first choice, followed by β-1actam antibiotics metronidazole in the antibiotics utilization. Conclusion The principle of antibiotics prophylaxis is hardly abided strictly during perioperative period. Improper utilization of antibiotics in perioperation period should be avoided and the reasonable advice for medicine utilization should be given to clinical physicians.