外科使用万古霉素303份病历分析

Analysis of 303 cases medical records vancomycin used in surgery

目的分析医院外科系统万古霉素的使用情况,为合理用药提供依据。方法选取2016-2018年医院使用万古霉素的外科系统病历303份,采用回顾性分析进行处方点评,分析用药情况、处方权限、微生物送检、血药浓度检测等。结果 303份外科病历分布于8个科室,骨科占比最多。使用万古霉素越权现象占35.24%(37/105),微生物送检率为95.71%(290/303),但药敏结果未得到重视,万古霉素血药浓度检测率为7.26%(22/303)。结论医院外科系统使用万古霉素、微生物送检、疗程等基本合理,但还存在改进方面,需要加强信息系统对万古霉素的越级使用和血药浓度检测的监管,提高临床医师对药敏结果的重视意识。

Objective To analyze the application of vancomycin in the surgical system of a hospital,provide the basis for rational drug use.Methods 303 cases of medical records using vancomycin in the surgical system in a hospital from 2016 to 2018 were selected.A retrospective analysis was used for prescription comment,analysis of drug use,prescription authority,microbial testing,blood drug concentration testing,etc.Results The 303 cases of surgical records were distributed in 8 departments,accounting for the largest proportion in the department of orthopedics.In the case of vancomycin,35.24%(37/105) of the patients had exceeded their authority,and the microbial detection rate was 95.71%(290/303).However,no attention was paid to the drug sensitivity results,and the detection rate of vancomycin blood drug concentration was 7.26%(22/303).Conclusion The selection of vancomycin for use in the surgical system of a hospital,microbial testing,course of treatment,etc.,is basically reasonable,but there are still some improvements,it is necessary to strengthen the information system for the use of vancomycin beyond the grade and blood drug concentration detection supervision,improve the awareness of clinicians to drug sensitivity results.