肿瘤专科医院Ⅰ类切口手术围术期抗菌药物使用分析

Antibiotics application during perioperative period of typeⅠincision surgery in tumor hospital

目的了解肿瘤专科医院介入手术、乳腺、甲状腺3种Ⅰ类切口手术抗菌药物使用情况,从而采取相应的干预措施,达到围术期合理使用抗菌药物的目的。方法从2011年6月-2012年6月出院病历中随机抽取303份患者病历,对抗菌药物的品种、联合使用、疗程等进行合理性分析。结果 303例患者中预防性使用抗菌药物者共99例,预防用药率为32.67%;98例为静脉滴注给药;使用排名前3位的抗菌药物依次为哌拉西林/舒巴坦、萘夫西林、头孢唑林,使用率分别为19.19%、18.18%、11.11%;19例术前30min^2h使用抗菌药物;术后平均用药3.3d;抗菌药物的使用以单一用药为主,共85例,占85.86%,二联用药12例,占12.12%,三联用药2例,占2.02%。结论Ⅰ类切口手术预防用药存在使用率偏高、用药起点高、用药时间过长、重复给药等问题,应加强抗菌药物管理,促进临床合理用药。

OBJECTIVE To understand the status of antibiotics application during the three type I surgeries including the interventional surgery, breast surgery, and thyroid surgery so as to take the corresponding intervention measures to achieve the goal of rational use of antibiotics during perioperative period. METHODS A total of 303 medical records of patients who were discharged from Jun 2011 to Jun 2012 were randomly selected, then the rationality of use of antibiotics, combination use of antibiotics, or treatment course was observed. RESULTS Of totally 303 cases of patients, 99 have used the prophylactic antibiotics with the rate of 32.67%, and 98 cases were treated with intravenous administration of antibiotics. The cefoperazone-sulbactam, nafcillin, and cefazolin ranked the top three kinds of used antibiotics with the utilization rates of 19.19%, 18. 18%, and 11.11%,respectively. There were 19 cases of patients who used antibiotics 30 rain-2 h before operatiom the average postoperative medication course was 3.3 days; there were 85 （85.86%） cases of patients with one-drug medication,12 （12. 12%） cases with two-drug medication, and 2 （2. 02%） cases of three-drug medication. CONCLUSION There are some problems existing in type I incision surgery, such as high utilization rate, high starting point of medication, overlong time of medication, and repeated administration and so on, therefore, the management of antibiotics should be strengthened so as to promote the reasonable clinical medication.