泌尿外科微创碎石术预防使用抗菌药物调查分析

Investigation and Analysis of Preventive Application of Antibiotics in Minimally Invasive Lithotripsy of Urology Department

目的了解泌尿外科微创碎石手术围手术期预防使用抗菌药物情况及存在问题，加强抗菌药物使用管理。方法调查2012年5月至2013年8月160例泌尿外科微创碎石手术患者资料，其中2012年5～12月为管理前组，2013年1-8月为管理后组，在预先设计的表格上逐项填写调查内容，对围手术期预防性应用抗菌药物的使用率、用药时间、给药时机、使用品种等情况进行统计分析。结果160例患者中围手术期抗菌药物使用率100％，管理后组抗菌药物的平均使用时间为（2．16±1．08）d，显著短于管理前组的（5．18±2．91）d，（P〈0．05）；术前0．5～2h使用合格率由管理前组的68．75％提高到管理后组的91．25％，（P〈0．05）；应用的药物由管理前组的6大类11个品种集中到管理后组3大类4个品种。结论围手术期抗菌药物的使用存在不合理性，经质控管理后明显好转，需继续加强政策调控。

Objective To understand the preventive applications of antibiotics and existing problems during perioperative period of minimally invasive lithotripsy of urology department and strength management of antibiotics. Method Clinical data of 160 patients accepted minimally invasive lithotripsy from May 2012 to August 2013 were selected and divided into two groups. Data from May to December 2012 was in before-management group and the other was in after-management group. Research content was recorded in a pre-designed form. The use rate, time of administration, opportunity for administration and use of varieties were analyzed. Results All of the 160 patients were treated by antibiotics and the use rate was 100% during perioperative period. The average time of using antibiotics in afteranagement group was （2.16±1.08） d, which was significantly shorter than before-management group （5.18±2.91） d （P〈0.05）. The eligible rate of 0.5-2h before operation was 68.75% in before-management group and 91.25% in after-management group. The difference was significant （P〈0.05）. The varieties of medicine was 4 varieties 3 categories in after-management group, which was 11 varieties 6 categories in before-management group. Conclusion Use of antibiotics was irrational during perioperative period. But under quality management, the situation had improved markedly.