医院腹部外科围手术期抗菌药物应用调查

Analysis of antibiotic application during perioperative period of abdominal surgery

目的观察腹部外科围手术期抗菌药物应用情况,为抗菌药物的规范管理及合理使用提供参考。方法随机选择腹部外科出院病历500份,对围手术期抗菌药物的选择、用法、给药方式、病原学检查、用药时机及时间等进行统计分析。结果抗菌药物使用率90.0%;静脉给药91.1%、口服4.4%、肌内注射4.4%;使用1～3种抗菌药物分别为17.8%、68.9%、13.3%;使用第三代头孢菌素共270例,二代头孢菌素240例;抗厌氧菌药物210例、其他160例次,共应用抗菌药物16种,4.7%患者做细菌培养;抗菌药物1次/d给药71.1%;2次/d占17.8%;3次/d占11.1%;术前和术后短程应用抗菌药物20.7%,术后应用抗菌药物79.3%,平均10.3 d。结论医院腹部外科使用抗菌药物种类选择基本合理,用药途径正确,也存在某些不合理用药现象,应实施针对性对策以合理应用抗菌药物。

OBJECTIVE To observe the use of antibiotics during perioperative period of abdominal surgery,so as to provide reference for standard management and rational use of antibiotics.METHODS A total of 500 discharge medical records underwent abdominal surgery were randomly selected.The choice of antimicrobials,usage,administration method,etiological examination,and administration timing and duration were statistically analyzed.RESULTS The use rate of antimicrobials was 90.0%;intravenous injection was performed in 91.11% cases,oral administration in 4.4%,and intramuscular injection in 4.4%;use rates of 1,2 and 3 antimicrobial agents were 17.8%,68.9% and 13.3%;270 cases received the third-generation cephalosporins and 240 cases received the second-generation cephalosporins;210 cases received anti-anaerobic bacteria drugs and other drugs were used in 160 case-times.Totally 16 antibiotics were used.4.7% patients received bacterial culture test.The administration of antibacterial drugs for 1 time/d accounted for 71.1%,2 times/d 17.8%,and three times/d 11.1%.Preoperative and postoperative short-time use of antibiotics accounted for 20.7% and postoperative use accounted for 79.3%.The mean duration was 10.3 days.CONCLUSION The selection of antimicrobial agents during perioperative period of abdominal surgery is basically reasonable.Administration route was correct.However,there is also phenomenon of unreasonable antibiotics usage.We should implement specialized strategies to reasonably apply antibiotics.