2467例Ⅰ类切口手术围术期预防性应用抗菌药物分析

Analysis on Prophylactic Application of Antibiotics in 2467 Patients with Type Ⅰ Incision Surgery During Perioperative Period

目的：了解Ⅰ类切口手术围术期预防应用抗菌药物的情况,探讨抗菌药物专项整治活动的成效,为临床合理用药提供参考。方法：选取2015年河源市人民医院2 467例Ⅰ类切口手术患者,对其围术期抗菌药物的预防性应用情况进行回顾性统计分析。结果：2 467例Ⅰ类切口手术患者中,567例预防性使用抗菌药物,抗菌药物预防性使用率为22.98%;预防性使用的抗菌药物主要为五水头孢唑啉、头孢呋辛、头孢硫脒;术前0.5-1.0 h预防性给药率为95.24%（540/567）;预防性用药疗程〈24 h者76例（占13.40%）,〉48 h者392例（占69.14%）;骨科与神经外科Ⅰ类切口手术围术期预防性用药率高、用药时间长。结论：Ⅰ类切口手术围术期预防性使用抗菌药物的管理取得了一定的成效,但仍存在不合理用药现象。应进一步加强干预力度,特别是对问题突出的科室,以促进抗菌药物的合理应用。

OBJECTIVE： To investigate the application status of prophylactic antibiotics in type Ⅰ incision during perioperative period,and to probe into the efficacy of antibiotics rectifications,so as to provide reference for the rational application of drugs in clinic. METHODS： 2 467 patients with type Ⅰincision surgery in Heyuan People＇s Hospital in 2015 were extracted,and retrospectively statistical analysis was conducted on the application status of prophylactic antibiotics in type Ⅰ incision surgery during perioperative period. RESULTS： Of the 2 467 patients,567 cases had prophylactic application of antibiotics,and the rate was 22. 98%; the prophylactic antibiotics were mainly cefazolin pentahydrate,cefuroxime and cefathiamidine; the prophylactic application rate before surgery of 0. 5-1. 0 h was 95. 24%（ 540 /567）. Patients with prophylactic treatment course 24 h was 76 cases（ 13. 40%）, 48 h was 392 cases（ 69. 14%）. The rate of prophylactic application of antibiotics was high and the treatment course was long in orthopedics and neurosurgery department. CONCLUSIONS： The prophylactic application of antibiotics for the typeⅠincision surgery has achieved some success,yet there were still some irrational phenomenon. It is necessary to further strengthen the interventions,especially for the departments with many problems,so as to promote the rational application of antibiotics.