白内障超声乳化围手术期抗菌药物的预防性应用

Investigation of perioperative prophylactic utilization of antibiotics in phacoemulsification and intraocular lens implantation

目的:了解我院白内障超声乳化围手术期抗菌药物预防性应用情况。方法:采用病例回顾的方法,对我院眼科2009-11/2012-11期间1 156例白内障超声乳化手术,就围手术期使用抗菌药物种类、用药时间、给药时机、切口愈合情况等进行统计分析,并进行合理性评价。根据感染高危因素的数量分别统计抗菌药物全身使用率。结果:围手术期局部使用抗菌药物1 156例,占100%。静脉使用抗菌药物者166例(14.36%)。对于具有2个全身性感染高危因素者,全身使用抗菌药物的比率为72.09%。对于具有3个全身性感染高危因素者,全身性使用抗菌药物比率为100%。所有切口均为甲级愈合,无术后感染病例。结论:自2009-11以来我院白内障超声乳化术围手术期抗菌药物预防性应用基本符合规范,在术后局部抗菌药物的使用时长上尚需进一步规范。另外,建议卫生部组织专家尽快制定我国眼科清洁切口手术围手术期预防性应用抗菌药物的临床指南。

AIM： To investigate the perioperative prophylactic utilization of antibiotics in phacoemulsification and intraocular lens implantation patients in ophthalmology department of our hospital. METHODS： A total of 1156 cases underwent phacoemulsification and intraocular lens implantation from November, 2009 to November, 2012 in our hospital was included. Category of antibiotics, administration time point, medication time, wound healing were analyzed statistically and the rationality of above indexes was evaluated. RESULTS： All 1156 cases received prophylactic antimicrobials by local application in the perioperative period （100%）. The utilization rate of the antibacterials systematically of 1156 patients was 166 （14.36%） ; The utilization rate of the antibacterials systematically in patients with two systemic infection risk factors was 72.09%; The utilization rate of the antibacterials systematically in patients with three or more systemic infection risk factors was 100%. All incisions were healed well with no postoperative infections. CONCLUSION ： The perioperative prophylactic utilization of antibiotics in phacoemulsification and intraocUlaf lens implantation patients was meeting the standard of the ministry of health. In addition, the ministry of health organization was advised to formulate the clinicalguidelines on perioperative prophylactic utilization of antibiotics in eye operation.