2290例围手术期预防应用抗菌药物调查

Analysis of Perioperative Prophylaxis Antibiotics in 2290 Cases of Patients with Surgical Incision

目的:调查围手术期抗菌药物预防性应用情况,促进抗菌药物合理应用。方法:采用回顾性调查的方法,对2290例Ⅰ、Ⅱ类切口手术患者围手术期预防性应用抗菌药物进行统计分析。结果:术前>24 h、2～24 h、<2 h及术后预防性使用抗菌药物者分别占10.96%,10.92%,25.06%,53.06%。Ⅰ类切口平均用药时间5.77 d,>3 d者761例(80.70%);Ⅱ类切口平均用药时间6.08 d,>3 d者1177例(87.38%)。Ⅰ类切口单一、二联用药比例分别为76.56%和23.44%;Ⅱ类切口单一、二联、三联用药比例分别为39.87%,58.43%和1.70%。Ⅰ类切口手术符合预防用药指征882例(93.53%)。发生手术部位感染12例,感染率0.52%,感染发生与用药疗程无相关性(P>0.05)。结论:加强围手术期合理用药监督,进一步规范围手术期预防性抗菌药物的应用非常重要。

Objective： To investigate the status of perioperative prophylaxis antibiotics in patients with surgical incisions of type Ⅰ or type H and to facilitate the rational use of perioperative antimicrobial agents. Method： The way of retrospective survey was taken to statistically analyze the perioperative antimicrobial prophylaxis in 2290 cases of patients with surgical incision of type Ⅰ or type Ⅱ . Result： The administration of perioperative antibiotics given 24 h, 2 -24 h and 2 h before the operation and after it accounted for 10.96% , 10.92%, 25.06% and 53.06% respectively, and the mean time of taking antibiotics was 5.77 days in incisions of type Ⅰ, and 761 cases （80.70%） were given antibiotics for more than 3 days. The mean time was 6.08 days in incisions of type Ⅱ, and 1177 case （ 87.38% ） were given for more than 3 days. The percentage of being given a single antibiotic and two antibiotics combined in type Ⅰ was 76.56% and 23.44% , respectively. The percentages of being given a single antibiotic, two antibiotics combined and three medicines combined in type Ⅱ were 39.87%, 58.43% and 1.70% respectively. 882 case（93.53% ） had the indications of antibiotics in incisions of type 1.12 cases of surgical site infection （SSI） occurred in type Ⅰ and Ⅱ incision. The occurrence was 0.52%. The SSI was not related with the course of antimicrobial administration （P 〉 0.05 ）. Conclusion： It is very important to strengthen the management and the rational use of antibiotics in perioperation.