某“三甲”医院Ⅰ类切口手术围术期预防使用抗菌药物调查分析

Analysis of Perioperative Prophylactic Application of Antibacterials in Type Ⅰ Incision Operation in a Class A Grade Three Hospital

目的:为Ⅰ类切口手术围术期合理预防使用抗菌药物提供参考。方法:随机抽取某"三甲"医院2013年3月-2015年2月Ⅰ类切口手术患者4 201例,对Ⅰ类切口手术围术期预防使用抗菌药物进行回顾性分析。结果:在4 201例Ⅰ类切口手术患者中,预防使用抗菌药物2 399例(占57.10%)。预防使用抗菌药物以头孢菌素、β-内酰胺类/β-内酰胺酶抑制剂为主,分别占45.60%、19.76%;头孢唑林、头孢曲松、阿莫西林钠克拉维酸钾的使用频次位于前3名。其中,预防用药时机不适宜的频数为823(占34.31%),预防用药疗程>48 h的频数为855(占35.64%)。结论:该院Ⅰ类切口手术围术期预防使用抗菌药物不合理情况仍然存在,应加强抗菌药物的监管,定期进行抗菌药物合理使用专题讲座学习,以促进抗菌药物的临床合理使用。

OBJECTIVE：To provide reference for perioperative rational prophylactic application of antibacterials in type Ⅰ incision operation. METHODS：4 201 patients underwent type Ⅰ incision operation were collected from a class A grade three hospital during Mar. 2013-Feb. 2015. The perioperative prophylactic application of antibacterials in type Ⅰ incision operation were analyzed statistically. RESULTS：Of 4 201 patients underwent type Ⅰ incision operation,there were 2 399 cases of prophylactic application of antibiotics（accounting for 57.10%）. Cephalosporins and β-lactam/β-lactamase inhibitor were the main classes of antibacterials for preventive use,accounting for 45.60% and 19.76%,respectively. The frequency of using cefazolin,ceftriaxone and amoxicillin-clavulanic acid ranked the top 3 places,among which there was 823 cases of unsuitable prophylactic medication time（34.31%）,and 855 cases of prophylactic medication time〉 48 h（accounting for 35.64%）. CONCLUSIONS：There still is unreasonable perioperative prophylactic application of antibacterials in type Ⅰ incision operation in this hospital. It is necessary to strengthen the supervision of antibacterials and conduct regular rational antibacterials use seminars in order to promote rational use of antibacterials.