480例Ⅰ类切口手术围术期预防性应用抗菌药物调查与分析

Investigation and Analysis on Preventive Application of Antibiotics in 480 Cases of Type ⅠIncision During Perioperative Period

目的:了解某部队医院(以下简称"该院")Ⅰ类切口手术围术期预防性应用抗菌药物的情况,为提高预防性用药的合理性提供参考。方法:随机抽取该院2014—2015年Ⅰ类切口手术病例,每月抽取20例,共480例,调查分析围术期预防性用药情况。结果:该院Ⅰ类切口手术主要为骨关节手术、乳腺手术、甲状腺手术和腹股沟疝手术。其中,围术期抗菌药物预防性使用率为79.8%(383/480),术前0.5~1.0 h给药率为90.6%(347/383),预防性用药疗程>24 h患者所占比例为73.6%(282/383),预防性用药疗程最长为15 d,手术感染率为0.5%(2/383)。预防性使用率排序居前5位的抗菌药物分别为头孢替安、头孢硫脒、头孢呋辛、头孢唑林、克林霉素。讨论:该院Ⅰ类切口手术围术期预防性应用抗菌药物仍存在一些问题,应加强管理,促进围术期合理预防性用药。

OBJECTIVE ：To investigate the preventive application of antibiotics in type I incision during perioperative period in an army hospital （hereinafter referred to as ＂the hospital＂ ）, so as to provide reference for the improvement of rationality of preventive drug application. METHODS： 20 cases of type I incision were monthly and randomly extracted from the hospital during 2014-2015, totally 480 cases. The preventive application of antibiotics in type I incision were analyzed during perioperative period. RESULTS： The type ~ incision operation cases were mainly for the joint surgery, breast surgery, thyroid surgery and inguinal hernia surgery. Among which, the preventive application rate of antibiotics during perioperative period was 79. 8% （383/480）, the administration rate of 0. 5 h-1.0 h was 90. 6% （347/383）, the ratio of number of patients with preventive treatment course 〉 24 h was 73. 6% （282/383）, and the longest treatment course was 25 d, the surgical infection rate was 0. 5% （2/383）. The top 5 antibiotics ranked by preventive application rate were respectively cefotiam, cefathiamidine, cefuroxime, cephazolin and clindamycin. DISCUSSIONS： There are still some problems in the preventive application of antibiotics in type I incision during perioperative period, it is necessary to strengthen the management, so as to promote the rational preventive application of antibiotics.