某三级医院Ⅰ类切口手术抗菌药物应用情况分析

Analysis of the application of antibacterial drugs in typeⅠincision surgery in a tertiary hospital

目的调查分析某三线城市三级医院Ⅰ类切口手术预防性使用抗菌药物情况。方法利用医院药品信息系统采用简单随机抽样法抽取2013—2016年Ⅰ类切口手术病例,记录患者基本信息及抗菌药物使用情况,汇总分析抗菌药物使用现状,评价围手术期预防使用抗菌药物的合理性。结果 948例Ⅰ类切口手术病例中预防性使用抗菌药物共计220例,使用率为23.21%;其中不合理用药共计80例,合理率为91.56%。预防用药存在问题以给药时机不适宜为显著,在不合理病例中占比47.50%,其中尤以术后给药居多。结论该院Ⅰ类切口手术抗菌药物预防使用较合理,但仍存在少数给药时机不适宜、遴选药品不适宜等不合理应用抗菌药物现象。对于目前存在的问题应针对性的开展培训,加强用药干预,进一步规范Ⅰ类切口手术围手术期抗菌药物的临床应用,提高用药合理性。

Objective To investigate and analyze the preventive use of antibaCTerial agents for type Ⅰ incision surgery in a tertiary hospital in a third-tier city. Methods The hospital drug information system was used to extraCT typeⅠ incision surgery cases from 2013 to2016 by simple random sampling method. The basic information of patients and the use of antibaCTerial drugs were recorded,the status of antibaCTerial drugs was summarized and analyzed,and the rationality of prophylaCTic use of antibiotics during perioperative period was evaluated. Results There were 220（ 23. 21%） cases of prophylaCTic use of antibiotics in 948 patients with type Ⅰ incision operation,the use rate was 23. 21%,of which there were 80 cases of unreasonable drug use. The reasonable rate was 91. 56%. The problem of prophylaCTic drug use is improper time of administration,which accounted for 47. 50% of the unreasonable use,especially the improper time of the postoperative administration of medicine. Conclusions The prophylaCTic use of antibiotics in the typeⅠincision operation is relatively reasonable,but there are still a few unreasonable applications of antibaCTerial drugs,such as inappropriate time of drug delivery and inappropriate seleCTion of drugs. In order to solve these problems,we should carry out targeted training,strengthen drug intervention,and further standardize the clinical application of perioperative antibiotics in typeⅠincision surgery to improve the rationality of drug use.