444例Ⅰ类切口手术围手术期预防用抗菌药物调查分析

Perioperative Application of Prophylactic Antibacterial in 444 Patients Undergoing Type Ⅰ Incision Operation

目的了解某医院I类切口手术围手术期预防用抗菌药物的情况,评价用药合理性,为抗菌药物的临床应用管理提供数据支持。方法回顾性调查某院2010年7～12月归档病历中I类切口手术患者有关抗菌药物的预防性应用情况并进行分析。结果444例I类切口手术患者均使用了抗菌药物,使用率为100%。在初次给药方面,术前0.5～2h、2～24h和大于24h用药者分别为12例、122例和63例;术后用药者247例。在持续给药中,术后预防用药时间小于4d者70例、4～7d者193例、大于7d者181例。术后单一用药者占82.43%,二联用药者占17.12%,三联用药者占0.45%。结论该院I类切口手术预防性使用抗菌药物存在指征把握不严、抗菌药应用档次过高、无指征联合用药及给药时机不当等问题,有待进一步加强管理。

Objective To investigate the prophylactic antibacterial used in patients with type I incision operation,to evaluate the proper usage and strengthen the management of prophylactic antibacterial application.Methods Patients with type I incision operation were sampled from July to Dec.2010 in a hospital.The general data and drug application of the patients were analyzed statistically by questionnaire.Results Among all the 444 cases,444 cases used antibacterial for prophylaxis,the use rate was 100%.The utilizations of antibacterial were 12 cases、122 cases、63 cases respectively at 0.5～2h、2～24h and more than 24h before surgery,247 cases were given antibacterial after surgery in the initial delivery time.374 cases of patients were treated by antibacterial beyond 3d.There were 82.43% for one drug use、17.12% for two antibacterial use and 0.45% for three drug use.Conclusion There are some problems in the prophylactic antibacterial use for patients with type I incision operation in this hospital,such as the irrational indications of drug use,the high selection of prophylactic drug use,improper time of drug use,and the prolonged continuous drug use,which require strengthening the standardized management for prophylactic antibacterial use.