腹股沟疝修补术与甲状腺疾病手术和乳腺疾病手术3种Ⅰ类切口预防使用抗菌药物分析

Inguinal hernia repair and thyroid diseases surgery and breast surgery 3 kinds of incision prevention use of antibiotics analysis

目的探讨3种常见Ⅰ类手术切口预防使用抗菌药物情况,评价其合理性。方法分别查阅2013年5月至2014年5月广东省云浮市人民医院所有腹股沟疝修补术病历117份、甲状腺疾病手术病历181份和乳腺疾病手术病历63份,对其预防使用抗菌药物的使用比例、药物品种选择合理性、术前首次用药时间、总预防用药时间和药物使用频率进行分析。结果腹股沟疝修补术、甲状腺疾病手术和乳腺疾病手术预防使用抗菌药物比例分别是23.9%、18.2%、14.3%。抗菌药物品种选择合理比例分别是25.0%、30.3%、33.3%。术前首次给药时间合理比例分别是75.0%、30.3%、66.7%。总预防用药时间<24 h比例分别是78.6%、72.7%、44.4%。腹股沟疝修补术预防感染以头孢硫脒为主,其使用频率是25.0%。甲状腺疾病手术预防用药以头孢替安和头孢西丁为主,使用频率均是27.3%。乳腺疾病手术以头孢替安为主,其使用频率是44.4%。结论根据抗菌药物全国专项整治方案要求,以上3种切口原则不使用抗菌药物预防感染。该院上述3种手术切口预防使用抗菌药物比例偏高,且药物品种选择合理比例偏低,需要采取措施严格控制与加强管理。

Objective To analyze the preventive usage antibacterials of three common operative incisions Ⅰ to evaluate the rationality.Methods Respectively,in May 2013-May 2014 Yunfu People＇s Hospital of Guangdong Province all the inguinal hernia repair medical records 117 cases,181 cases of thyroid disease surgical records and 63 cases of breast disease surgery,the use of antimicrobial drugs to prevent the use of the proportion of drug selection is reasonable Sex,preoperative time of first medication,total time of prophylaxis and frequency of drug use were analyzed.Results The ratios of preventive usage antibacterials in inguinal hernia herniorrhaphy、thyroid diseases operation and breast diseases operation were 23.9%,18.2%,14.3%,respectively.the ratios of selecting antibacterials correctly above operations were 25.0%,30.3%,33.3%,respectively.the ratios of reasonable first preoperative administration time above operations were 75.0%,30.3%,66.7%,respectively. the ratios of total administration duration 24 h above operations were 78.6%,72.7%,44.4%,respectively. cefathiamidine was used mainly in inguinal hernia herniorrhaphy. the ratio was 25.0%. cefotiam was used mainly in thyroid diseases operation and breast diseases operation. the ratio was 27.3%,44.4%, respectively.Conclusion Above three operative incisions are not necessary to use antibacterials preventively in principle base for the guideline of special antibacterials management. However,the ratios of preventive usage antibacterials in our hospital above three operative incisions are high and the ratios of selecting antibacterials correctly are low. measures is taken to control preventive usage antibacterials strictly.