妇科肿瘤患者围手术期抗菌药物使用的调查分析

Survey and analysis of antibiotics application in gynecological tumor patients during perioperative period

目的调查分析妇科肿瘤患者围手术期抗菌药物的使用情况,为合理使用抗菌药物提供参考数据。方法查阅2015年1月-6月妇科肿瘤患者符合围手术期要求的1066份病历,进行回顾性研究。结果围手术期妇科肿瘤患者抗菌药物的总使用率为98.78%;单药使用为术前用药的主要方式,占术前给药总病例的99.33%;二联用药为术后主要给药方式（占术后71.70%）,主要以硝基咪唑类联合头孢米诺、哌拉西林舒巴坦最为常见;给药时机主要为术前30 min至术前2 h,占术前给药病例的96.96%;Ⅰ类切口抗菌药物使用率为80.88%,Ⅱ~Ⅳ类切口抗菌药物使用率均为100.00%;Ⅱ类切口占总病例数的87.05%,该类中68.53%预防用药时长在大于48 h至5 d范围之间。结论围手术期抗菌药物的使用存在不合理现象,应加强和规范围手术期抗菌药物的应用及管理。

OBJECTIVE To investigate the status of the perioperative application of antibiotics in gynecological tumor patients. METHODS A retrospective survey of 1066 gynecological tumor patients in our hospital with operative records between January 2015 and June 2015 were performed. RESULTS The utilization rate of antibiotics was 98.78% in gynecological tumor patients during perioperative period; single drug for preoperative treatment accounted for 99.33%, two-drug for postoperative treatment accounted for 71.70%, the most common combinations were nitroimidazoles united cefminox or piperacillin sulbactam; the most common administration time was between 30 min and 2 h before operation, accounted for 96.96%; the utilization rates of antibiotics from type I -IV incision surgery were 80.88%, 100%, 100%, 100% respectively; the type Ⅱ incision surgery accounted 87.05%, in which the patients with prophylaxis medication time over 48 h and within 5 d accounted for 68.53%. CONCLUSION There is partly irrational application of antibiotics usage in gynecological tumor patients during perioperative period, it is necessary to strengthen the management of anbioties and standardize the perioperative application of antibiotics continuously.