我院2014年骨科Ⅰ类切口手术围手术期预防使用抗菌药物分析

Analysis of Prophylactic Use of Antibacterials in Perioperative Period for Type Ⅰ Incision Surgery in Orthopedics of Our Hospital in 2014

目的：评价我院2014年骨科I类切口手术围手术期预防使用抗菌药物合理性，为加强抗菌药物临床应用管理提供参考。方法：回顾性分析我院2014年1．6月骨科I类切口手术患者围手术期预防使用抗菌药物情况。结果：调查骨科I类切口手术共472例（其中有人工植入物手术318例，无人工植入物手术154例），围手术期抗菌药物预防使用率85.38％（其中有植入物手术预防使用率94．03％，无植入物手术预防使用率67．53％）；抗菌药物品种选择合理率72．21％，给药时机合理率（术前0．5～2h内给药）94．54％，剂量合理率76．67％；平均预防用药时间（3．28±1．94）天。结论：2014年我院骨科I类切口手术围手术期不合理预防使用抗菌药物现象仍然存在，主要表现为预防使用率高、品种选择不合理、预防用药时间长、用药剂量大等，需加强管理，促进骨科I类切口手术围手术期合理预防使用抗菌药物。

Objective：To evaluate the prophylactic use of antibacterials in perioperative period for type I incision surgery in orthopedics of our hospital in 2014 and to provide a reference for intensifying the management of clinical use of antibacterials. Methods：A retrospective analysis was conducted to study the prophylactic use of antibacterials in perioperative period for type I incision surgery in orthopedics of our hospital during January to June of 2014. Results：About 472 cases of type I incision surgery in orthopedics were analyzed （including 318 cases of artificial implant surgery and 154 cases of no artificial implant surgery）, the rate of perioperative use of antibacterials for prophylaxis was 85.38% （of which 94.03% of antibacterials was used in artificial implant surgery and 67.53% of no artificial implants surgery）. The proportion of rational drug use was 72.21%, the rates of reasonable medication timing （antibacterials were used within 0.5 - 2 h before operation） and reasonable doses were 94.54% and 76.67% respectively, and the average duration of prophylactic drag use was （3.28 ± 1.94） days. Conclusion： The irrationality of perioperative use of antibaterials for prophylactic purpose for type I incisionsurgery still existed in choice of drug types, further strengthen the surgery in orthopedics. orthopedics of our hospital in 2014, such as the high usage rate of antibacterials, irrational too long medication duration for prophylaxis and improper dosage, etc. So it is necessary to management of prophylactic use of antibacterials in perioperative period for type I incision