解放军第175医院3种Ⅰ类切口手术预防性应用抗菌药物分析

Perioperative Use of Prophylactic Antibacterial Drugs in Patients Undergoing Three Kinds of Type Ⅰ Incision Operations in The 175th Hospital of PLA

目的:评价我院3种Ⅰ类切口(甲状腺、乳腺、疝)手术预防性应用抗菌药物的合理性。方法:采用回顾性调查方法,对我院2010年出院的302例(甲状腺、乳腺、疝)Ⅰ类切口手术病历资料进行统计分析。结果:我院3种Ⅰ类切口手术围术期抗菌药物预防性应用率达100%,单一、二联、三联用药率分别为91.39%(276/302)、6.95%(21/302)和1.66%(5/302);预防用抗菌药物共9类,按使用频次排序居前4位的抗菌药物依次为头霉素类、头孢菌素类、β-内酰胺+β-内酰胺酶抑制剂复方制剂、氨基糖苷类;术前0.5～2 h给药仅1例,术前>2 h给药50例,术后继续使用率为100%;用药时间≤24 h者8例,24～48 h者25例,用药持续时间最长达17 d。结论:该院清洁手术围术期预防性应用抗菌药物存在指征掌握不严、品种选择欠妥、给药时间不恰当、术后用药时间过长等不合理现象,应进一步规范使用并加大监管力度。

incision operations was 100%, with mono-drug therapy, combinations of two and three antimicrobial drugs accounting for 91.39% （ 276/302 ）, 6. 95% （ 21/302 ） 1.66% （ 5/302 ）, respectively. The prophylactic antibiotics totaled 9 categories, which ranked in descending order according to use frequency were cephamycins, eephalosporins,β- lactam ＋ β-lactamase inhibitors compound preparation and aminoglycosides. 1 ease was administered with antibiotics within 0. 5-2 hours before operation, 50 cases 〉2 hours before surgery and 302 （100%） after operation. 8 received antibiotics for ≤24 hours and 25 for 24-48 hours after operation; the longest duration of antibiotic use was 17 days. CONCLUSION ： Irrational phenomena such as the non-strict mastering of the medication indication, improper selection of drug variety, inappropriate administration occasion and prolonged medication duration etc were noted in prophylactic antibiotic use for patients undergoing aseptic operations in this hospital. Measures should be taken to tighten control on standard perioperative antibiotic use.