我院5种Ⅰ类切口手术围手术期预防用抗菌药物调查分析

Analysis on Prophylactic Antibacterial Use in Five Kinds of Type ⅠIncision Operation

目的评价医院5种Ⅰ类切口手术围手术期预防用抗菌药物的合理性。方法回顾性调查2010年4月至12月出院的甲状腺手术、乳腺手术、疝气修补术、肿块切除术和大隐静脉曲张术275例Ⅰ类切口手术患者预防性应用抗菌药物情况。结果 275例患者中,抗菌药物预防性使用率为94.55%,涉及头孢菌素类和林可霉素类4种抗菌药物,使用频次排名分别为头孢噻吩钠、头孢唑林钠、头孢呋辛钠、克林霉素。术前应用<0.5 h者2例(占0.73%),0.5～2 h者245例(占89.09%),未用药者28例(占10.18%);术前未用术中应用5例(占1.82%);术后应用≤24 h者248例(占90.18%),未用27例(占9.82%)。平均住院费用6 854.80元,平均药品费用1 281.92元。抗菌药物总费用占住院总费用的1.14%,占住院药品总费用的6.10%。结论Ⅰ类切口手术围手术期预防用抗菌药物存在不合理现象,应采取有效措施进行干预。

Objective To evaluate the rationality of prophylactic antibacterial used in 5 kinds of type I incision operation. Methods The prophylactic antibacterial use during perioperative period in 275 surgical patients with type ] incision operations, including thyroid surgery, breast surgery, herniorrhaphy, oncotomy and great saphenous vein varicose surgery, discharged from April to December 2010 were retrospectively investigated. Results Among 275 cases, the rate of preventive antimicrobial use during perioperative period was 94.55%, involving 4 kinds of antibacterials cephalosporins and lincomyein. The ranking orders of usage frequency were cephalothin sodium, cefa- zolin sodium, cefuroxime sodium and clindamycin. Preoperative use 〈0.5 h was in 2 cases（0.73% ） and 0.5-2 h was in 245 eases （89.09%）. No preoperative antibacterial use was in 28 cases（10. 18% ）. Five cases did not use antibacterials preoperatively and used antibacterials intraoperatively（1.82% ）. Postoperative antibacterial use ~〈24 h was in 248 cases（90. 18% ）. No postoperative bacterial use was in 27 cases（9. 82% ）.The average hospitalization expenses were 6 854.80 Yuan and the average drug expenses were 1 281.92 Yuan. The total expenses of antibaeterials accounted for 1.14% of the total hospitalization expenses and 6. 10% of the total hospitalization drug expenses respectively. Conclusion Perioperative prophylactic antibacterial use still has unreasonable phenomena among type Iincision operations in our hospital. The effective measures should be adopted to intervene.