我院Ⅰ类切口预防用抗菌药评价

Evaluation of Prophylactic Application of Antimicrobials in the Perioperative Period of Type Ⅰ Incision Operations in our Hospital

目的：了解我院Ⅰ类切口围手术期抗菌药的使用情况,为进一步促进抗菌药的合理使用工作提供依据。方法：随机抽取我院2011年1月~2012年12月的Ⅰ类切口手术（腹股沟疝修补术、甲状腺疾病手术、乳腺疾病手术、颅骨肿物切除手术和经血管途径介入诊断手术）患者病历360份,从预防使用抗菌药指征、药物选择、预防用药对机、用药疗程、是否有联合用药情况及用法用量等指标,对我院Ⅰ类切口围术期抗菌药的使用合理性进行调查分析、评价。结果：Ⅰ类切口抗菌药预防使用率为28.61%,均为单一用药;使用抗菌药最多的是头孢唑林、其次为克林霉素;术前0.5~2.0 h内使用抗菌药的100例（97.09%）,术前〉2 h、〈0.5 h或术前不用术后用的共3例（2.91%）,抗菌药的合理使用率为66.99%。结论：我院5种Ⅰ类切口围手术期预防性使用抗菌药符合卫生部规定的要求,但仍存在问题,有待进一步规范化管理。

Objective：To study the prophylactic application of antimzicrobials in the perioperative period of type I incision operations to promote its rationality.Methods：360 medical records of type incision operation including hernioplasty for inguinal hernia,throid operations,operations of breast disease,operations of skull tumor resection and diagnosis of intervention were randomly selected during January 2011 to December 2012 to formulate the evaluation criteria for prophylactic application of antimicrobials in the perioperative period of type Ⅰ incision operations.Results：28.61%of the patients with type Ⅰ incision received prophylactic antimicrobials,and all of them were given single antimicrobial drug.Cefazolin was the most common drug they used,and then clindamycin;100 cases were given antimicrobials in 0.5-2 hours before operation,and 3 cases were not given in more than 2 hours or less than 0.5 hours before operation but given after it. The rational use of antimicrobial agents was 66.99%.Conclusion：Prophylactic application of antimicrobials in the perioperative period of type I incision operations was rational in our hospital.But there were some problems in the prophylactic application of antimicrobials,and therefore,it is important take some intervention measures to solve them.