我院Ⅰ类手术切口抗菌药物应用情况及对策  

Clinical Application of Antibacterials during Perioperative Period of I Type Incisions: Investigation and Strategy

作　　者：舒德忠[1] 钱敏[1] 尹华[1] 

机构地区：[1]重庆市涪陵中心医院,重庆涪陵408000

出　　处：《抗感染药学》2007年第2期86-89,共4页Anti-infection Pharmacy

摘　　要：目的:监测外科Ⅰ类手术切口应用抗菌药物情况,规范临床用药。方法:依据《抗菌药物临床应用指导原则》,从2006年1月起,每月对外科Ⅰ类手术切口抗菌药物使用情况按照给药时间、时程及药物种类等项目进行收集分析,并将结果和建议反馈给相关科室。结果:全年抽查病历分为1～6月(242例)和7～12月(256例)两部分,分别整理统计。498例(白内障手术除外)Ⅰ类切口全都使用了抗菌药物。7～12月术前0．5～2．0 h使用抗菌药物比例为76．94％,较上半年38．43％明显增加。术前未使用抗菌药物病例13．65％、术前使用时间大于2 h病例12．50％、术后使用时程等较上半年显著缩短;涉及脑、骨骼等器官的手术切口抗菌药物术后使用时间较长。大于3 h的手术几乎都未追加抗菌药物。抗菌药物选择如青霉素和第1、2代头孢菌素使用率由上半年32．86％在下半年上升到53．91％。抗菌药物联用和更换的病历显著减少。结论:外科Ⅰ类手术抗菌药物使用存在较多问题,经过对其监测,逐渐规范了使用,但仍有待提高。Objective： To explore the antibacterials use during perioperative period of i type incision and practical rational use of antibacterials. Methods： Clinic records of Ⅰ type incisions were investigated and analyzed monthly. The details of checkup were feedbacked to the relative departments. The rational antibacterials use standard was based on the guide principle of the clinical application of antibacterials published by Ministry of Health of the People＇s Republic of China in Aug.2004. Results： There were 498 cases of Ⅰtype incisions （except for cataract surgery） from Jan. 1. to Dec. 31. of 2006 in our hospital. There were 242 cases in the first half year and 256 cases in the last half year, compared with the two parts, the application rate in 0.5-2 h pre-operation rose to 76.84% in the last half year from 38.43% in the first half year of 2006; and the application period was shortened in post-operation, the situations of combined application and the frequent changes of drugs decreased. But the dosing period of antibacterials after operation in some cases were still longer, and there were rarely combined with the second continuous dose for the cases during operation, in which the period was longer than 3hours. Conclusions： The application of antibacterials during perioperative period was far from being reasonable before interventions. Through taking active and efficient measures, the irrational applications were prevented gradually, but the level ofantibacterials application remains to be improved.

关 键 词：抗菌药物 头孢菌素 用药分析 

分 类 号：R978[医药卫生—药品]