各级医院460例Ⅰ类切口手术抗菌药物预防性应用对比分析

Analysis on 460 cases of perioperative period prophylactic use of antibiotics of type I incision operation

目的了解各级医院Ⅰ类切口手术患者预防性应用抗菌药物的水平。方法从5家三级医院、3家二甲医院、5家二乙医院、3家一级医院(社区卫生院)中,回顾性、随机抽查460例Ⅰ类切口手术病历,对比分析预防用药适应证、用药品种、联合用药、给药时机及用药疗程。结果 460例患者均预防性使用抗菌药物,抗菌药物总品规数为568种,人均使用1.23种。用药不合理222例,占48.26%。其中,用药时机及用药疗程不合理198例次,占43.04%);选药不当150例次,占32.61%;联合用药无指征112例次,占24.35%。结论不同级别医院中,Ⅰ类切口手术患者围手术期抗菌药物应用合理性差异显著。

Aim To understand the status of perioperative prophylactic use of antibiotics at various levels hospitals for evaluating its rationality.Methods The medical records of 460 cases of typeⅠincision surgery were randomly checked at different levels of hospitals for statistical analysis on indications,drug categories,drug combination,medication timing and duration in perioperative prophylactic use of antibiotics.Results 460 cases used prophylactic antibiotics with total 568 varieties of drugs and per capita use of 1.23 varieties.222 cases were irrational（48.26%）.Preventive medication time and duration were not in conformity with the provisions in 198 cases（43.04%）,improper selection in 150 cases（32.61%）,no indication of drug combination in 112 cases（24.35%）.Conclusion In type Ⅰ incision operations among different levels of hospitals,there were significant differences for the rationality of use of antibiotics.