231例外科围手术期患者抗菌药物应用分析

Analysis of Application of Antibacterial Agents of 231 Cases of Surgery Patients during Perioperative Period

目的 了解该院外科围手术期患者抗菌药物的使用,为临床合理应用抗菌药物提供依据。方法 抽查该院2015年1月份骨科、心血管外科、心外监护室、乳腺外科、泌尿外科、普外科、口腔外科、器官移植中心、肝胆外科、神经外科、整形外科、胸外科、妇科、心内科的围手术期患者231例,对抗菌药物的合理性进行评价分析。结果 所调查的231例患者中,抗菌药物预防使用率为96.10%;其中术前0.5-2 h给药的181例（78.35%）,术前﹥2 h给药的26例（11.25%）,术中追加应用抗菌药物的42例（18.19%）,术后预防用药的199例（86.15%）;患者平均用药疗程为2.67 d,其中Ⅰ类切口患者平均用药疗程为1.81 d,Ⅱ类切口患者平均用药疗程为3.33天;围手术期抗菌药物的不合理应用主要集中在用药起点高、单次剂量过大、术后预防用药时间长、术前未用术后用等几个方面;抗菌药物平均费用为1219.32元,占药品费用的8.93%;围手术期抗菌药物有1例二联用现象。结论 医院对围手术期预防应用抗菌药物的综合干预监管明显。

Objective To know the use of antibacterial agents of surgery patients during perioperative period in our hospital and provide basis for the clinical rational application of antibacterial agents. Methods 231 cases of patients in the depart-ment of orthopaedics, department of cardiovascular surgery, extracardiac care unit, department of breast surgery, department of urinary surgery, department of general surgery, department of oral surgery, organ transplantation center, department of hepatobiliary surgery, sixth department of surgery, department of chest surgery, department of gynecology and second de-partment of cardiology in our hospital in January 2015 were extracted, and the rationality of antibacterial agents was as-sessed and analyzed. Results In the 231 cases of patients, the preventive utilization rate of antibacterial agents was 96.10%, the administration in 0.5-2 h before operation was in 181 cases （78.35%）, administration 〉2 h before operation was in 26 cases （11.25%）, the additional application of antibacterial agents in operation was in 42 cases （18.19%）, the preventive medication after operation was in 199 cases, （86.15%）, the average medication treatment course of patients was 2.67d, a-mong them, the average medication treatment course of patients with Ⅰtype incision was 1.81d, and the average medication treatment course of patients with Ⅱ type incision was 3.33d, and the unreasonable application of antibacterial agents during the perioperative period focused on the high medication starting point, excessive single dose and long preventive medication after operation, and the average cost of antibacterial agents was 1219.32 yuan, accounting for 8.93% in the drug cost, and the bigeminal phenomenon of antibacterial agents during perioperative period occurred to 1 case. Conclusion The hospital’s overall intervention supervision of the preventive application of antibacterial agents during perioperative period is obvious.