围手术期抗菌药物预防性使用的调查分析

Irestigotion of prophylactic use of antibiotics during perioperative period

目的调查围手术期抗菌药物预防性应用情况并进行合理性分析,为临床抗菌药物应用提供依据。方法随机抽取2012年6-11月外科手术患者747例,对抗菌药物预防性应用情况进行统计分析。结果Ⅰ类手术切口抗菌药物预防性使用率为72.91%,明显低于Ⅱ类和Ⅲ类切口的100.00%,平均用药时间Ⅰ类切口为(2.64±0.72)d,单一用药为主,Ⅱ类切口为(5.83±1.46)d,二联用药为主,Ⅲ类切口为(6.37±1.79)d,三联药物为主,上述比较差异有统计学意义(P<0.05);Ⅰ类切口抗菌药物不合理应用主要表现在适应证、给药时机、术后用药;Ⅱ类切口主要集中在给药时机、术中追加和术后用药;Ⅲ类切口主要集中在给药时机、术中追加、术后用药。结论围手术期抗菌药物预防性应用存在着较多的不合理现象,医院应制定相应的监督制度干预抗菌药物的临床使用。

OBJECTIVE To investigate the rationality of prophylactic use of antibiotics during perioperative period to guide the clinical use of antibiotics. METHODS A total of 747 patients who underwent surgery from Jun to Nov 2012 were randomly selected, the date regardig antibiotics prophylaxis was statistically analyzed. RESULTS The utilization rate of antibiotics prophylaxis for the type I incision surgery was 72. 91 %, significantly lower than that of the type II and type III incision surgery. The average administration time of the type I incision surgery was （2. 64±0. 72）d, with onedrug, the average administration time of the type IT incision surgery was （5.83 ±1. 46）d, with twodrugs , the average administration time of the type III incision surgery was （6. 37±1. 79）d, with threedrugs, the differences amony them were statistically significant （P〈 0. 05）. The unreasonable use of antibiotics for the type I incision surgery mainly included the indications, drug administration timing, and postoperative medication, for type II incision surgery mainly included the drug administration timing, intraoperative additional drug administration, and postoperative medication, for the type III incision surgery mainly included the drug administration timing, intraoperative additional drug administration, and postoperative medication. CONCLUSION The prophylactic use of antibiotics is not reasonable durimg perioperatire period, it is necessary for the hospital to develop corresponding supervision and intervention system for the clinical use of antibiotics.