胃肠外科围手术期合理使用抗菌药物的探讨

目的：分析胃肠外科围手术期抗菌药物的合理使用.方法：通过分析2015年1月-2017年12月期间胃肠外科500例手术患者的临床资料,针对患者围手术期抗菌药物的使用情况进行分析.结果：500例患者围手术期均有使用抗生素,其中使用率前三名的抗生素为硝基咪挫类（90.0%）、第三代头孢菌素类（75.0%）以及第二代头孢菌素类（40.0%）.Ⅰ类切口中单一用药22例,二联用药53例,三联用药3例;Ⅱ类切口中单一用药130例,二联用药250例,三联用药33例;Ⅲ类切口中二联用药3例,三联用药6例.结论：胃肠外科手术患者围手术期抗生素使用情况基本合理,少数患者存在用药指征把握不严格的问题,需要加强管理.

Objective： To analyze the rational use of antibiotics in perioperative period of gastrointestinal surgery. METHODS： We analyzed the clinical data of 500 patients undergoing gastrointestinal surgery between January 2015 and December 2017 and analyzed the use of antibiotics during the perioperative period. Results： 500 patients had antibiotics during the perioperative period, among which the top three antibiotics used were nitroimidazole （90.0%）, third-generation cephalosporins （75.0%）, and second-generation cephalosporins. Class （40.0%）. There were 22 single-agents in group I incisions, 53 in dual-agents and 3 in triples; 130 in single incision in group II; 250 in dual-agent and 33 in triple; and 3 in group III incisions. Triple medication in 6 cases. Conclusion： The perioperative use of antibiotics in patients with gastrointestinal surgery is basically reasonable, and there are problems in the minority of patients with impractical indications for the use of medications, and management needs to be strengthened.