湖南省儿童医院600例儿童围术期抗菌药物应用调查分析

Analysis of The Use of Perioperative Antibiotics in 600 Cases of Children in Children's Hospital of Hunan Province

目的:了解湖南省儿童医院外科手术围术期抗菌药物的使用情况,并作出客观评价。方法:随机抽取该院2011年7月至2011年12月外科手术住院病历600份,调查不同切口类型手术围术期预防使用抗菌药物的情况。对抗菌药物的选择、适应证、术前用药时间、联合用药及疗程等进行合理性评价。结果:围术期抗菌药物使用率为70.5%(423/600),Ⅰ类切口抗菌药物使用率达到55.0%(202/367),远高于卫生部不超过30%的规定。预防性抗菌药物选用起点过高,用药时间过长,不合理率为20.2%(121/600);联合用药、药物更换均存在不合理现象。结论:该院外科围术期抗菌药物应用仍存在选药档次偏高、药物品种选择欠适宜、术后预防用药时间偏长等问题,需继续加强对围术期抗菌药物使用的监督和指导。

Objective： To investigate the use of antibiotics during perioperative period in our hospital and to analyze the application of antibiotics and make an objective evaluation.Methods： The medical records of 480 patients who received operations from Jul.to Dec.in 2011 were collected to evaluate the use of perioperative antibiotics.The selection of antibiotics,indications,administration time before operation,combined chemotherapy and course of treatment were evaluated.Results： The application rate of antibiotics during perioperative period was 70.5%（423/600）,the rate in typeⅠincision operation was 55.0%（202/367） which is much higher than provide by Ministry of Health（30.0%）.The choosing antibiotics were high levels.The rate of over-protracted treatment period after operation was 20.2%（121/600）.There were some unreasonable cases with combined medications and antibiotics replacements.Conclusions： There are some problems in the use of perioperative antimicrobial agents in this hospital： high grades of drug selection,unreasonable drug selection and long course of the postoperative prophylaxis.Therefore,more efforts are needed to promote the reasonable antibiotics application during perioperative period.