2017—2019年天津市滨海新区汉沽中医医院Ⅰ类切口围手术期预防用抗菌药物的合理性分析

Analysis on the reasonable usage of prophylactic antibiotics in perioperative period of typeⅠincision in Hangu Hospital of Traditional Chinese Medicine in Tianjin Binhai New Area from 2017 to 2019

目的分析2017—2019年天津市滨海新区汉沽中医医院Ⅰ类切口围手术期抗菌药物预防使用情况,为规范Ⅰ类切口围手术期抗菌药物预防使用提供参考。方法抽取天津市滨海新区汉沽中医医院2017—2019年Ⅰ类切口手术病历共163例,对围手术期预防用抗菌药物情况及合理性进行评价与分析。结果163例患者中48例预防使用了抗菌药物,抗菌药物使用率为29.45%;抗菌药物品种选择排名第一的为头孢西丁,构成比为50%,头孢唑林、头孢替唑、氨曲南以及美洛西林舒巴坦,构成比均为12.50%;给药时机在术前0.5~1 h给药的有30例,占62.5%;用药疗程≤24 h的有30例,占62.5%;用法用量不适宜的有23例,其中头孢西丁17例、氨曲南6例。结论天津市滨海新区汉沽中医医院Ⅰ类切口围手术期预防用抗菌药物存在用药指征把握不严、品种选择不恰当、给药时机不恰当、用药疗程过长、用法用量不合理等问题,应加强管理,促进Ⅰ类切口围手术期抗菌药物合理应用。

Objective To analyze the usage of prophylactic antibiotiscs in perioperative period of typeⅠincision in Hangu Hospital of Traditional Chinese Medicine in Tianjin Binhai New Area from 2017 to 2019,and so as to provide reference for the prophylactic application of antibiotiscs in perioperative period of typeⅠincision.Methods A total of 163 medical records undergoing typeⅠincision operation in Hangu Hospital of Traditional Chinese Medicine in Tianjin Binhai New Area from 2017 to 2019 were randomly selected,and the usage of prophylactic antibiotics in perioperative period and rationality were evaluated and analyzed.Results In the 163 cases of patients,there were 48 cases of patients with prophylactic antibiotiscs,and the usage rate of antibiotics was 29.45%.In the ranking of selecting the types of antibiotiscs,the first one was cefoxitin,accounting for 50%.Cefazolin,ceftizole,aztreonam,mezlocillin and sulbactam all accounted for 12.50%.The cases of administration time 0.5—1 h before operation was 30,accounting for 62.5%.The proportion of patients with drug course within 24 h was 62.5%.The cases of unreasonableusage and dosage was 23,17 cases were the applications of cefoxitin,and 6 cases were the applications of aztreonam.Conclusion There are unreasonable phenomenon of antibiotics use in typeⅠincision operation in Hangu Hospital of Traditional Chinese Medicinein Tianjin Binhai New Area,especially including improper medication indications,incorrect choice of drugs,inappropriate timing of administration,long duration,unreasonableusage and dosage.It is necessary to strengthen the management of antibiotiscs,and so as to promote the rational use of antibiotics in clinic.