西宁地区12家医院Ⅰ类切口预防性应用抗菌药物合理性分析

Analysis of the Rationality of Prophylactic Use of Antibiotics for Type Ⅰ Incision in 12 Hospitals of Xining Area

目的:为Ⅰ类切口患者合理应用抗菌药物提供参考。方法:抽取2007年10月～2008年3月西宁地区12家医院骨科、普外科、妇科的Ⅰ类切口归档手术病历1 024份,对预防性应用抗菌药物情况进行调查。结果:Ⅰ类切口预防性应用抗菌药物达100.0%,无指征用药为28.4%,其中术前0.5～2h应用率为16.9%,术前>2h应用率为33.4%,术前不用术后用应用率为49.7%;存在抗菌药物品种选择不当、联用不规范、用法用量不合理、应用时间过长、更换药品无依据等不合理、不规范使用情况。结论:该地区医院Ⅰ类切口患者预防性应用抗菌药物存在诸多问题,亟需加强规范化管理。

OBJECTIVE： To provide reference for patients with type Ⅰ incisions about rational use of antibiotics. METHODS： Between Oct. 2007 and Mar. 2008, a total of 1 024 medical records of patients with type Ⅰ incisions from orthopaedics, common surgery, department of gynecology in 12 hospitals of Xining area were sampled for analysis of prophylactic use of antibiotics. RESULTS： 100.0% of the type Ⅰ incision patients received prophylactic antibiotics; 28.4% used antibiotics without indication; 16.9% used antibiotics at 0.5-2 h before operation; 33.4% used antibiotics at more than 2 h before operation; and 49.7% received antibiotics postoperatively rather than preoperatively. The irrational and nonstandard use of antibiotics manifested as improper in the choice of drug variety, nonstandard in drug combination, irrational in dosage and administration, prolonged use of antibiotics, lacking basis for the change of drug variety etc. CONCLUSION： The prophylactic use of antibiotics in patients with type I incisions from 12 hospitals of Xining area is far from perfect, therefore, it is urgent to strengthen the standard management on the use of antibiotics.