119例阑尾炎手术患者抗菌药物预防应用调查分析

Investigation and analysis on the prophylactic application of antimicrobial agents in 119 patients with appendicitis operation

目的分析阑尾炎手术患者抗菌药物应用情况,并进行评价。方法抽取某院普通外科2006年全年阑尾炎住院手术患者病历119份,统计其抗菌药物应用情况。结果119例阑尾炎手术患者抗菌药物使用率为100%,使用最多的抗菌药物为头孢菌素类,例次使用率为41.50%;硝咪唑类抗菌药物使用率为37.82%。Ⅱ、Ⅲ类切口手术部位感染率分别为1.92%、6.67%,两者比较,差异有显著性(χ2=8.16,P<0.05)。Ⅱ类切口使用1种或2种抗菌药物者手术部位感染率为1.27%,使用≥3种抗菌药物者手术部位感染率为4.00%,两者差异无显著性(χ2=0.54,P>0.05)。术后使用抗菌药物时间偏长者占87.39%,给药频率不当者占63.03%,无联合用药指征给药者占26.89%。结论目前外科抗菌药物的使用还存在较多问题,需要加强管理。

Objective To evaluate and analyse the application of antimicrobial agents in patients with appendicitis operation. Methods One hundred and nineteen medical records of patients with appendicitis operation in a general surgical department in a hospital in 2006 were chosen, the application of antimicrobial agents was analysed statistically. Results The usage rate of antimierobial agents of 119 patients was 100%, the most commonly used antimierobial agents was eephalosporins, the usage frequency was 41. 50%; the usage frequency of nitiomidazoles was 37.82%, the surgical wound infection（SWI） rate of class Ⅱ and Ⅲ incision was 1.92% and 6. 67% respectively, there was significant difference between the two （X^2 = 8.16, P〈0.0%）. SWI rate of classⅡ incision was 1.27% in patients receiving 1 or 2 antimierobial agents, and SWI rate of class Ⅱ incision was 4. 00% in patients receiving at least 3 kinds of antimierobial agents, there was no significant difference between the two （x^2 = 0. 54, P〉0.05）. 87.39%, 63.03% and 26.89% patients received long duration, inappropriate and non-indication application of antimicrobial agents respectively. Conclusion There are many problems in the application of antimierobial agents, the management of antimierobial agents should be strengthened.