心脏起搏器植入术围术期预防性抗菌药物使用分析及围术期护理体会

Application analysis of prophylactic antibacterial in perioperative cardiac pacemaker implantation and its nursing experience

目的分析本院心脏起搏器植入术围术期预防性抗菌药物使用情况以及在使用过程中存在的问题。方法对125例心脏起搏器植入术围术期预防性抗菌药物使用情况进行回顾性调查分析。结果使用的抗菌药物涉及头孢菌素类、青霉素类、喹诺酮类以及林可霉素类4大类,其中抗菌使用率最高的是头孢呋辛,占55.2%,其次是头孢美唑,占21.6%;抗菌药物用量最多的是头孢呋辛,其次为头孢美唑钠;平均用药时间(3.2±1.3)d;术后有1例感染,给予头孢呋辛抗感染,并及时将切口处消毒换药处理,术后第9天拆线出院。结论本院心脏起搏器植入术围术期预防性抗菌药物选择给药方面较为合理,但仍存在一定比例的不合理用药,并且还存在用药量过大及用药时间过长的问题,因此还需进一步加强管理,坚决将不合理用药使用率最大化降低。

Objective To analyze the use of prophylactic antibacterial in perioperative cardiac pacemaker implantation and the problems in perioperation. Methods The application condition of prophylactic antibacterial in perioperative cardiac pacemaker implantation patients in our hospital was retrospectively analyzed. Results The use of antibacterial involved in four categories including cephalosporins,penicillins,quinolones and lincomycin,the most utilization in frequency was cefuroxime（ 55. 2%）,followed by cefmetazole（ 21. 6%）. The largest dosage was cefuroxime,followed by cefmetazole sodium. The mean drug application time was（ 3. 2 ± 1. 3） d. One patient was infected.After given cefuroxime and incision disinfection in time,the patient was discharged after nine days.Conclusion Prophylactic antibiotics application in perioperative pacemaker implantation is reasonable in the study,but still presence with unreasonable medication,excessive medication and longer medicine time. Therefore,management should be strengthened to minimize irrational drug usage.