Ⅰ类清洁手术围手术期预防用抗菌药物调查

Survey of the precautionary application of antibiotics in clean surgical operations during perioperative period

目的:了解普外科清洁手术(Ⅰ类切口)患者围手术期抗菌药物预防应用情况,评价其合理性,为后期的围手术期抗菌药物干预研究提供参考。方法:对2010年6月–2011年5月324例符合条件患者病历资料进行回顾性调查分析。结果:324例患者全部使用了抗菌药物,预防用药率100%;在手术前0.5～2 h用药者50例(15.4%),手术前2～24 h用药者64例(19.8%),手术后用药者185例(64.8%);持续用药时间≤1 d的16例(4.9%),≤3 d的80例(24.7%),4～7 d的198例(61.1%),>7 d的46例(14.2%);手术后预防用药时间为1～16 d,平均5.3 d。预防用药品种最多为克林霉素磷酸酯169例,其他以青霉素和二、三代头孢菌素为主。结论:该院I类切口手术预防性应用抗菌药物存在明显不合理现象,应加强干预管理。

Objective： To get more information about the precautionary application of antibiotics in clean surgical operations（type I of incision） during operative period,and evaluate the rationality to offer some useful information for the study of the precautionary application of antibiotics.Methods： We had a retrospective method to analyze 324 cases selected from June 2010 to May 2011.Results： We found that the ratio of the precautionary application of antibiotics in all 324 cases was 100%;50 cases（15.4%） were given antibiotics 0.5-2 hours before operations;64 cases（19.8%） were given antibiotics 2-24 hours before operations;185 cases（64.8%） received antibiotics after operations.Regarding to continuing time of antibiotics,16 cases（4.9%） ≤1 d,80 cases（24.7%） ≤ 3 d;198 cases（61.1%） last 4-7 days and 46 cases（14.2%） using more than 7 days after operations.The precautionary medication time after operations was 1-16 days,and the average time was 5.3 days.The most kind of antibiotics used in 324 cases was clindamycin phosphate,which was used in 169 cases,and others were penicillin,second or third generation of cephalosporin.Conclusion： Irrational phenomenon about the precautionary application of antibiotics existed in clean surgical operations（type I of incision）,and we should take more intervention and management.