900例剖宫产手术围手术期预防用抗菌药物使用分析

Analysis on Perioperative Use of Prophylactic Antibiotics for 900 Patients Undergoing Cesarean Section

目的分析本院剖宫产手术围手术期抗菌药物的使用情况,评价用药合理性,进一步指导临床合理应用抗菌药物。方法查阅2013-07~12期间,900例行剖宫产手术病例,对其预防性使用抗菌药物情况进行回顾性分析。结果 900例剖宫产手术抗菌药物使用率达99.7%。抗菌药物共计8种,其中头孢呋辛、头孢孟多酯使用频率最高。术前0.5~2 h用药7例（0.8%）,术中结扎脐带后给药621例（69.3%）,术后用药242例（27.1%）。术后抗菌药物使用疗程,小于24 h者567例（63.3%）,24~48 h之间者203例（22.7%）。抗菌药物单用865例（96.1%）,二联用药31例（3.4%）。不合理用药情况共194例次（21.7%）,其中出现频率最高的是术后用药疗程过长126例次（64.9%）、选药档次过高40例次（20.6%）。结论本院剖宫产手术围手术期预防使用抗菌药物存在用药时间长、用药档次偏高等问题,需加强监管。

OBJECTIVE To investigate the application of antimicrobial prophylaxis in cesarean section,and promote the rational use of antibiotics. METHODS Retrospective investigation and analysis were conducted in 900 cases of cesarean section which selected from July to September in 2013.RESULTS Among 900 cases of cesarean section,the use rate of antibiotics was 99.7%. 8 kinds of antibiotics were counted,in which cefuroxime and cefamandole sodium had the highest use rate. Antibiotics were given 0.5-2 h before operation in 7（ 0.8%） cases,621（ 69.3%） were given after the umbilical cord be clamped and 242（ 27.1%） were（ 63.3%）,and during 24-48 h in 203 cases（ 22. 7%）. 865 cases（ 96. 1%） received single antibiotic and 31 cases（ 3. 4%） received two-drug combination use. 194 cases（ 21.7%） contained irrational use of antibiotics,in which the medication for a long time after operation（ 126 cases,64. 9%） and high-grade drugs（ 40 cases,20. 6%） had the highest use rate. CONCLUSION The perioperative use of prophylactic antibiotics for patients undergoing cesarean section in the hospital is rational,but the medication for a long time after operation,high-grade drugs and other issues need to be improved.