清洁切口手术围术期抗菌药物应用与分析

Application of antibiotics during perioperative period of clean surgery

目的探讨清洁切口手术围术期预防应用抗菌药物的合理性。方法回顾性调查医院2011年1-3月564份清洁切口手术患者的出院病历,围术期抗菌药物使用情况按事先设计的表格进行检查,并进行统计分析。结果有431例、451例次患者使用抗菌药物,使用率为76.4%,例次使用率为80.0%,平均用药时间3.5d;术后<24h停药32例,占7.4%;切开皮肤前30min～2h给药的351例,占81.4%;使用青霉素类196例次,占43.4%,第一、二代头孢菌素147例次,占32.6%,三代头孢菌素的21例次,占4.7%;单一用药421例,占97.6%。结论清洁切口手术围术期用药在抗菌药物适应证、药物选择、用药疗程均存在不合理现象,提示清洁切口手术围手术期抗菌药物的规范化使用有待进一步提高。

OBJECTIVE To explore the rationality of prophylactic use of antimicrobial agents during the perioperative period of clean surgery. METHODS A retrospective survey on the medical records of 564 patients who underwent clean surgery and discharged from Jan to May 2011 was conducted, the status of application of antibiotics during the period was reviewed by the prepared questionnaire and analyzed statistically; RESULTS There were 431 patients （451 case-times ） who used antibiotics with the utilization rate of 76. 4%, the mean medication duration was 3.5 d; 32 patients stopped using less than 24 h after the surgery, accounting for 7.4% 351 patients were with dosing 30 rain-2 h before the skin incision surgery, accounting for 81.4% -196 case-time of patients used penicillin, accounting for 43.4%, the first and second generation of eephalosporins by 147 case-times （32. 6%）, the third generation of cephalosporins by 21 case-times （4. 2%）; 421 patients use single-drug, accounting for 97.6 %. CONCLUSION There remains irrational phenomena in indications of using antibiotics, drug selection, and medication course, which indicates that the use of antibiotics during the perioperative period of clean surgery needs to be further standardized.