卵巢囊肿患者围手术期抗菌药物使用调查分析

Investigation and analysis of perioperative use of antimicrobial drugs in patients with ovarian cysts

目的:了解妇科卵巢囊肿手术患者围手术期预防性使用抗菌药物的情况。方法:回顾性分析2011年1–6月某院卵巢Ⅰ类手术切口患者预防性使用抗菌药物的情况,对其合理性进行分析、评价。结果:174例患者预防性抗菌药物使用率为100%,无感染病例发生;抗菌药物使用频次由高到低依次为:硝基类、二代头孢、青霉素类;预防性抗菌药物二联使用率为81.03%;预防性用药多在术前>2 h和术后使用;术后持续用药时间>48 h的患者占82.76%;手术持续时间<2 h术后仍用药的患者占87.93%。结论:某院妇科卵巢Ⅰ类手术切口预防性使用抗菌药物存在不合理现象:妇科Ⅰ类切口围手术期用药指征控制不严;用药品种掌握不合理;围手术期预防性抗菌药物联用现象频繁;围手术期预防性使用抗生素的时机选择不当;手术后预防性使用抗生素的时间过长;手术时间较短患者术后不宜给药;应进一步加强围手术期预防性使用抗菌药物的监督和管理,规范卵巢Ⅰ类手术切口围手术期抗生素的预防性应用。

Objective： To comprehend the application of preventive antimicrobials in perioperative period in the gynecology patients with ovarian cyst surgery.Methods： The application and rationality of preventive use of antimicrobials in the patients with ovarianⅠtype incision were retrospectively analyzed and evaluated from January to June in 2011.Results： The utilization rate of preventive antimicrobials in 174 patients was 100%.There was no infection case.The use frequencies of antimicrobials in an order from high to low were nitro,the second-generation cephalosporins and penicillins.The rate of combination use of two kinds of prophylactic antimicrobials was 81.03%.Most of preventive antibiotics had been taken more than 2 hours before surgery or after surgery.The rate of taking antibiotics more than 48 hours after surgery was up to 82.76% among all the patients.The rate of using antibiotics after the surgery in patients with surgery duration less than 2 hours was 87.93%.Conclusion： There were several irrational phenomenons on use of preventive antimicrobials in the patients with ovarianⅠtype incision.The medication indications of preventive antimicrobials in surgery of gynecologicalⅠtype incision had not been controlled strictly.The selection of preventive antimicrobials was not reasonable.Perioperative combination use of prophylactic antimicrobials was too frequent.The medication time of perioperative prophylactic antibiotics was inappropriate.The course of taking prophylactic antibiotics after surgery was too long.The patients with the simple and short-time operations were not appropriate to take antibiotics after surgery.So we must strengthen the supervision and management of the perioperative prophylactic use of antimicrobials,and regulate the use of prophylactic antibiotics in ovarianⅠtype incision surgery in perioperative period.