Ⅰ类切口手术326例围术期预防性使用抗菌药物分析

Analysis on the perioperative prophylactic application of antibiotics in 326 cases of typeⅠincision operation in our hospital

目的 了解该院Ⅰ类切口手术患者预防性使用抗菌药物情况,促进临床合理用药.方法 采用回顾性研究方法,随机抽取2011年1～12月Ⅰ类切口手术（甲状腺手术、乳腺手术、腹股沟疝修补术）患者出院病历326份,对围术期预防性应用抗菌药物情况进行分析.结果 326例Ⅰ类切口手术患者中,使用抗菌药物185例,抗菌药物预防使用率为56.75%;单一用药、联合用药率分别为88.11%（163/185）、11.89%（22/185）;术前0.5～2.0h、〉2h用药分别为118例（77.63%）、34例（22.37%）,术后预防用药时间：≤48h 136例（73.51%）、3～7d 43例（23.24%）、〉7d 6例（3.24%）.结论 该院Ⅰ类切口手术患者预防性使用抗菌药物基本合理,但仍存在指征把握不严、药物选择欠妥、用药时机不当以及用药时间过长等问题,应针对存在问题采取干预措施.

Objective To investigate the status and rationality of prophylactic use of antibiotics in patients with type I incision operation in our hospital so as to promote rational use of drugs. Methods Prophylactic application of antibiotics in 326 patients undergoing type I incision operation （thyroid operation, breast operation and hernia operation） from Jan. to Dec. in 2011 was investigated retrospectively. Results Among 326 cases, prophylactic application of antibiotics accounted for 56. 74% （ 185 cases）. Single use and combined use of antibiotics were 88.11% （163/185） and 11.89% （22/185） respectively. The utilizations of antibiolics were 77.63 % （ 118 cases）, 22.63 % （ 34 cases） 0.5 - 2 h, 〉 2h before surgery . After operation, 136 cases （73.51%） were given antibiotics in less than 48 hours,43 cases （23.24%） for 3 - 7days and 6 cases （3.24%） for more than 7days. Conclusion The prophylactic use of antibiotics in patients with type I incision operation in our hospital was basically rational, but there were some problems such as the indications was not strict, the category of the antibiotics was not properly chosen,improper medication timing and excessive drug use etc, intervention measures needs to be taken to tackle these problems.