Ⅰ类切口围手术期抗菌药物使用的调查研究

Investigation of antibiotic application during perioperative period of typeⅠincision surgery

目的了解医院Ⅰ类切口手术预防使用抗菌药物情况,加强外科围手术期抗菌药物使用管理。方法选取2011年6-10月某三级甲等医院全部Ⅰ类切口手术病历1395份,在预先设计的表格上逐项填写内容,采用趋势卡方检验统计分析合格率变化趋势。结果Ⅰ类切口手术抗菌药物使用率75.77%,用药时机合格率60.43%,用药时间合格率17.71%;使用最多的抗菌药物是头孢西丁、头孢替安、哌拉西林/舒巴坦;经医院的强化管理,Ⅰ类切口围手术期抗菌药物使用率越来越低,呈不断下降的趋势(χ2=111.32,P<0.01);用药时间合格率呈不断增加的趋势(χ2=77.44,P<0.01)。结论目前围手术期抗菌药物的使用存在不合理性,经质控管理,用药情况好转,需继续加强政策调控。

OBJECTIVE To know the status of the prophylactic use of antibiotics during the type Ⅰ surgery and strengthen the management of antibiotic application during the perioperative period.METHODS A total of 1395 cases of type Ⅰ surgery being taken from Jun to Oct 2011 were reviewed by professional personnel of hospital infections,then the forms were filled out one by one and were statistically analyzed,and the changing trend of qualified rate was examined by chi-square test.RESULTS The utilization rate of antibiotics was 75.77% during the type Ⅰ surgery,the qualified rate of the medication timing was 60.43%,the qualified rate of the duration of antibiotic prophylaxis for surgery was 17.71%.The most frequently used antibiotics were cefoxitin,cefotiam,and piperacillin/sulbactam.By the hospital＇s intensive management,the utilization rate of antibiotics during the perioperative period of type Ⅰ surgery was increasingly decreased,keeping a downward trend（χ2=111.32,P 0.01）;the qualified rate of the antibiotic application time showed an increasing trend（χ2=77.44,P0.01）.CONCLUSION The use of antibiotics during the perioperative period is unreasonable,and the medication is improved after the quality management,it is necessary to continue to strengthen the policy control.