抗菌药物在小儿外科围手术期的临床应用

Analysis of the Clinical Application of Antibiotics During the Perioperative Period of Pediatric Surgery

目的探讨小儿外科围手术期抗菌药物应用情况,为儿外科临床合理、规范使用抗菌药物提供参考。方法随机抽取2018年1-12月在四川省人民医院小儿外科出院手术病历500份,对围手术期抗菌药物的应用情况进行分析。结果500份手术病历中212例患儿使用了抗菌药物,围手术期抗菌药物总使用率为42.4%,I类手术切口为28.2%。抗菌药物使用频次排名分别为头孢唑林91人次(42.9%),头孢西丁钠61人次(28.8%),头孢硫脒29人次(13.7%),美洛西林舒巴坦钠19人次(9.0%),其他抗菌药物(硝基咪唑类、大环内酯类等)12人次(5.6%)。手术切口预防使用抗菌药物的合理性评价中,抗菌药物给药时机合理率较低(55.2%)。结论小儿外科围手术期抗菌药物目前应用存在一定的不合理,临床各相关科室之间加强协调合作,促进小儿外科围手术期抗菌药物合理应用。

Objective To investigate the clinical application of antibiotics during the perioperative period of pediatric surgery and provide references for the rational and standardized application of antibiotics in pediatric surgery.Methods The 500 surgical records of pediatric surgery from January of 2018 to December of 2018 in Sichuan Provincial People’s hospital were randomly selected to analyze the application of antibiotics during the perioperative period.Results Among the 500 surgical records,212 children were treated with antibiotics.The total application rate of antibiotics during the perioperative period was 42.4%and that of the children with type I incision was 28.2%.The frequencies of antibiotic use were 91(42.9%)for cefazolin,61(28.8%)for cefoxitin sodium,29(13.7%)for cefathiamidine,19(9.0%)for mezlocillin sulbactam sodium,and 12(5.6%)for the other antibiotic agents such as nitroimidazoles,macrolides,etc.In the evaluation of rationally using antibiotics in the surgical incision,the rational rate of antibiotic administration timing was 55.2%.Conclusion The application of antibiotics during the perioperative period of pediatric surgery is unreasonable to some extent.The coordination and cooperation among clinical departments should be strengthened to promote the rational use of antibiotics during the perioperative period of pediatric surgery.