我院骨科Ⅰ类切口预防使用抗菌药物情况分析

Prophylactic Use of Antibiotics for Type Ⅰ Incision in Orthopedic Surgery in Our Hospital

目的分析大理市第一人民医院骨科I 类切口手术预防使用抗菌药物的情况，为合理使用抗菌药物提供参考。方法从H I S 系统筛选出2 0 1 5 年9 月?2 0 1 6 年2 月我院骨科I 类切口手术病例4 2 0 份，针对病例是否使用抗菌药物、是否有用药指征、抗菌药物选择、预防用药时机、疗程等进行数据收集，根据《抗菌药物临床应用指导原则》、《中华人民共和国药典临床用药须知》、《国家抗微生物治疗指南》及药品说明书等对其用药合理性进行评价和汇总。结果I 类切口手术共有4 2 0 例，使用抗菌药物的例数为8 9 ,使用率21. 3 7 % 。抗菌药物使用合格例数为3 9 5 ,合格率9 4 .0 5 % 。在使用的抗菌药物中， 一、二代头孢占76. 4 0 % 。术前0 . 5 ?l h 给药的例数为8 3 , 占比9 3 .2 6 % 。用药疗程< 4 8 小时7 8 例，占87. 6 4 % 。结论我院骨科I 类切口预防使用抗菌药物基本合理，但不合理用药依然存在，需要进一步规范和持续改进。

Objective To analyze the prophylactic use of antibiotics for type I incision in orthopedic surgery in NO.1 People's Hospital of Dali to provide a reference for rational use of antibiotics. Methods 420 cases of type I incisions in orthopedic surgery were selected from HIS system between September 2015 and February 2016. The data for the cases were collected based on use antibacterial drugs,medication indications,choice of antibiotics,time for prophylactic usage of antibiotics and period of treatment. According to the Guidelines for the Clinical Use of Antibacterial Drugs,the Regulations on Clinical Drug Use of People's Republic of China Pharmacopoeia,the National Guidelines for Antimicrobial Treatment and the drug instructions. the rationality of antibiotic use was evaluated. Results Among the 420 cases of Type I incisions for orthopedic operations,89 of them were treated with antibiotics,with the rate of 21. 37%. 395 cases were qualified for the use of antibiotics,accounting for 94. 05%. Among of the used antibacterial drugs,the first and second generation of cephalosporins took up 76. 40%. 83 cases were treated with antibiotics 0. 5 ~ 1 h before operation,accounting for 93. 26%. 78 cases had the treatment course of less than 48 hours,accounting for 87. 64%. Conclusion The use of antibiotics for type I incision for orthopedic operation in the hospital is basically rational,but irrational drug use still exists,which needs further standardization and continuing improvement.