1030例骨科围手术期抗菌药物合理应用分析

Antibiotic Usage in Perioperative Period of 1030 Patients in Orthopedics Department

目的了解医院骨科围手术期抗菌药物的应用情况。方法随机抽取医院2007年1月～2009年12月骨科手术病历1030份．填写患者基本情况和用药情况调查表，对数据进行统计、分析。结果1030例骨科手术患者100．0％使用抗菌药物，其中使用1种抗菌药物者601例（58．3％），先后使用2种抗菌药物者330例（32．0％），使用了3种抗菌药物者99例（9．7％）；预防使用抗菌药物频率最高的是二线头孢菌素类，包括头孢噻肟、头孢哌酮、头孢地嗪、头孢米诺等，占71．0％；其次是其他β-内酰胺中氨曲南，占22．0％；给药途径多为静脉注射或静脉滴注，少数为口服或外用，抗菌药物给药平均时间为7d。结论骨科围手术期抗菌药物的预防性使用存在用药时间长、剂量大、选药档次高，亟须加强规范化管理。

OBJECTIVE To know about the antibacterial application of perioperative period in Orthopedics department of our hospital. METHODS 1030 surgery cases were chosenrandomly from Jan, 2007 to Dec, 2009 in Orthopedics department of our hospital. Questionnaire were filled out to collect basic information of patients. The information was analysed. RESULTS All 1030 patients were used antibacterials. Among which 601 cases, 58.3% were used one kind of antibacterials, 330 cases （32.0%） were applied two kinds of antibaeterials before and after operation, and 99 cases （9. 7%） were utilized three kinds of antibacterials. Second Cephalosporins was most common used in antibacterials including Cefotaxime, Cefoperazone, Cefodizime, Cefminox, and so on, accounting for 71.0~ ; The second usual was small-Aztreonam belonging to 13-1aetam, accounting for 22.0%. IVIg and Ivgtt were the most common routes of administration, minority was oral taking and external using. Average time usage of antibaeterials was 7 days. CONCLUSIONS The three most important problems are long term use, large dose, and high-grade of antibacterials in patients＇ perioperative period of Orthopedics department, which should be managed regularly.