我院3种清洁手术围术期抗菌药应用调查分析

Analysis of Antibiotics Applications During Perioperative Periods in Patients Undergoing Three Types of Aseptic Operations in Our Hospital

目的:探讨外科3种常见清洁手术(甲状腺手术、乳腺手术、骨科手术)预防性应用抗菌药情况。方法:回顾性调查我院2008年10～12月102例3种清洁手术患者预防性应用抗菌药情况。结果:102例手术期患者抗菌药预防性应用率达100%,平均用药时间5.37d。术前应用≤2h者36例(占34.29%),术前未用术中用者14例(占13.33%),术后应用≤24h者为0例,24～48h者为6例(占5.71%),绝大部分(73例占69.52%)手术术后给药时间达3d≤t≤7d。预防性应用抗菌药涉及6类,种类最多的为头孢菌素类;涉及药品28种,使用频次列第1位的为夫西地酸钠。平均住院药品费用3 726.67元,住院抗菌药总费用占总药品费用的40.92%。结论:我院3种清洁手术预防性应用抗菌药存在不合理现象,应引起重视。

Objective：To study the prophylactic use of antibiotics during perioperative periods in patients undergoing thyroid surgery, breast surgery or bone surgery. Method：The case records of 102 patients undergoing thyroid surgery, breast surgery or bone surgery in the last quarter of 2008 were retrospectively reviewed regarding the prophylactics use of antibiotics. Result：All of the patients （ 100% ） received antibiotics, and the average time of using antibiotics was 5.37 days. About 34.29% of the cases （36 patients） received antibiotics within 2 hours before the operation and 13.33% patients did not receive any antibiotics before the operation but during it. All of the patients did not stop using antibiotics within 24h after the operation, but 5.71% stopped within 48h after the operation. Most of the patients （ about 69.52% ） received antibiotics more than 3 days and usually stopped within 7 days after the operation. Of 6 categories of antibiotics used, dominating the first place were cephalosporins. A total of 28 kinds of antibiotics were involved and leading the first place on the list of DDDs was sodium fusidic. The patients＇ total drug cost was 3 726.67 yuan on average, with the cost of antibiotics accounting for 40.92%. Conclusion：Great attention should be paid to the serious problem of irrational use of prophylactic antibiotics in perioperative periods in this hospital.