肠癌手术患者围手术期抗菌药物使用情况研究

Analysis on Perioperative Use of Antimicrobial Agents in Colorectal Cancer with Colorectal Surgery

目的:调查肠癌手术患者围手术期抗菌药物使用情况,为临床合理使用抗菌药物提供理论依据。方法:收集我院2008年1月至2010年12月进行结直肠癌外科手术的病例134例。回顾性调查围手术期(术前、术中及术后)抗菌药物品种、联合用药、持续时间、术后感染的发生率。结果:134例患者围手术期全部使用抗菌药物,甲硝唑231例次(占35.6%),庆大霉素128例次(占19.7%),头孢菌素类127例次(占19.6%),喹喏酮类药物92例次(占14.2%),β-内酰胺类71(占10.9%)。用药时程≤3天、3-7天、>7天患者的术后感染率分别为:8.3%、6.5%、24.2%,用药时程≤3天和3-7天组术后感染率无显著性差异(P>0.05),但>7天组术后感染率显著高于一周内停药的患者(P<0.01)。围术期单药、二联和三联及以上用药的比率分别为20.1%、55.3%、27.6%,但各组术后感染的发生率无统计学差异(P>0.05)。结论:我院肠癌手术围术期抗菌药物的使用仍存在术后预防性使用抗菌素时间过长,药物选择不合理,药物起点高,联合用药组合多等现象,有必要进一步加强围手期抗菌药物使用管理,确保安全临床合理用药。

Objective：To explore the perioperative use status of antimicrobial agents in colorectal cancer patients with colorectal surgery,so as to provide the information for rational clinical use.Methods：A total of 134 colorectal cancer patients with colorectal surgery were enrolled in this study.The data of kindss of antimicrobial agents,combination use,usage during,infection after operation were collected and analyzed.Results：Antimicrobial agents were used by all the patient in perioperative during.Nitramisole（231,35.6%）,aminoglycosides（128,19.7%）,cephalosporins（127,19.6%）,fluoroquinolones（92,14.2%）,and β-lactams（71,10.9%） were used in our investigation.The percent of infection after operation in ≤3d、3~7d、7d group were 8.3%,6.5%,and 24.2%,respectively.The percent of infection in 7d group was higher than that in ≤3d or 3~7d group（P0.01）.No difference of infection percents was found between ≤3d and 3~7d group（P0.05）.The percent of single drug,combination use with two drugs,combination use with three drugs or more accounted for 20.1%,55.3%,and 27.6%,respectively.No difference of infection percents was found between every groups（P0.05）.Conclusion：Antimicrobial drug use in colorectal cancer patients with colorectal surgery has long usage during,more randomness,higher starting point and more combination use,which need to strengthen management further.