Ⅰ类手术切口预防性使用抗菌药物分析

Application of prophylactic antimicrobial agents in operation I incision

目的分析我院Ⅰ类切口手术预防性使用抗菌药物情况,为临床合理用药提供参考。方法随机抽取2013年2月～8月Ⅰ类切口手术出院病历723份,对病历中使用抗菌药物的情况进行统计和分析。结果723份病历中,预防使用抗菌药物217份,使用率达30%。预防使用抗菌药物病历中,合理使用191份（88%）,不合理使用26份（12%）,首剂术前未用术后用比率为7.8%,总预防用药时间＆gt；24h的比率为7.4%,品种选择不当比率为3.2%,联合用药（二联及以上）比率为1.4%。使用频率最高的前2位药品为头孢唑林和头孢呋辛。存在的主要问题是抗菌药物使用用药时间不适宜,同时存在部分用药品种选择不当和不必要的联合用药。结论经过近3年的抗菌药物专项整治以及等级医院评审我院Ⅰ类切口手术抗菌药物预防性使用整体得到改善,同时,还存在以用药时间不适宜为主的问题以及其他个别问题,涉及护士执行力与麻醉科的协调问题,医院需应继续加强Ⅰ类切口手术抗菌药物合理使用的教育、培训、监督和检查,完善相关的管理制度,以促进合理用药。还应进一步强化临床医师合理应用抗菌药物的意识,加强围手术期抗菌药物临床应用的管理,提高合理用药水平。

Objective To analyse and review the type I incision operation in prophylactic use of antibiotics, and to provide reference for clinical rational drug use. Methods From February to August 2013,randomly selected type I incision operation of 723 medical records were analysed.Results In these 723 patients,prophylactic antibiotics wereused in 217 cases（userateof30%）. Therationalusewerein 191（88%）, theirrationalusewerein 26（12%）. The total preventive use time more than 24 hours were of 7.4%, inappropriate species selection were of 3.2%, and combined use of drugs（two and above） ratio were of 1.4%. The highest frequency of use of 2 drugs were of cefazolin and cefuroxime.Themain problem was that the time of antibacterial drugs administration was not suitable. At the same time,there were some improper drugs selection and unnecessary compound use.Conclusion After nearly three years of antibacterial drugs use reformation, type I incision operation antimicrobial prophylactic use is overall improved. We should further strengthen theeducation,trainingand supervision ofrationaluseofantibacterialdrugs..