Ⅰ类切口手术预防性应用抗菌药物调查分析

Investigation and analysis of preventative application of antibacterial drugs in class Ⅰ incision surgery

目的了解本院围术期Ⅰ类切口手术抗菌药物使用情况,加强抗菌药物的使用管理,评价其合理性。方法抽取2013年1~12月该院Ⅰ类切口手术（乳腺手术、甲状腺手术、疝气修补术）病历512例,对抗菌药物使用情况进行统计分析。结果围术期Ⅰ类切口手术抗菌药物使用者378例,使用率为73.83%;合理用药218例,合格率为57.67%,不合理用药160例,占42.33%。所用抗菌药物涉及5类13种;术前0.5~2 h内给药240例（63.49%）,术后用药时间〉24 h 185例（48.94%）,用药时间〉48 h 102例（26.98%）。结论本院Ⅰ类切口手术患者预防性使用抗菌药物存在用药指征把握不严、抗菌药物选择不合理、用药时机不当、过度用药、用药时间过长、联合用药不合理等现象,有待进一步规范化管理。

Objective To investigate the usage of antibacterial drugs in the perioperative period of class I incision surgery in the hospital,strengthen the use management of antibacterial drugs and evaluate its rationality. Methods 512 cases of medical records on class I incision surgery （breast surgery,thyroid surgery and hernia repair） in the hospital from January to December 2013 were selected and the usage of antibacterial drugs was analyzed statistically. Results There were 378 patients who used antibacterial drugs in the perioperative period of class I incision surgery,with the usage rate of 73.83%,of which 218 patients were given rational drug use,with the pass percent of 57.67%,and 160 patients were given irrational drug use,accounting for 42.33%.The antibacterial drugs consisted of 5 categories and 13 types.240 patients （63.49%） were administered 0.5 to 2 hours before surgery,185 patients （48.94%） were administered more than 24 hours after surgery,and 102 patients （26.98%） were administered more than 48 hours after surgery. Conclusion Re- grading to the preventative application of antibacterial drugs in the perioperative period of class I incision surgery in the hospital,there still exist problems such as non-strict medication indications,irrational selection of antibacterial drugs,improper medication timing,excessive medication,overlong medication time and irrational drug combination,which require further standardized management.