妇科清洁手术围术期抗菌药物使用与安全性研究  

Application of antibiotics and safety research in gynecological aseptic operations during perioperative period

作　　者：华凯[1] 杨小华[1] 周萍[1] 

机构地区：[1]绍兴市妇幼保健院院办公室,浙江绍兴312000

出　　处：《中华医院感染学杂志》2011年第5期953-954,共2页Chinese Journal of Nosocomiology

基　　金：浙江省卫生厅科学研究基金项目(2008B183)

摘　　要：目的明确妇科清洁手术不使用抗菌药物的安全性和可行性，为临床提供循证医学证据。方法选择一定时期内该院所有妇科清洁手术病例作为研究对象，根据《抗菌药物临床应用指导原则》决定是否使用抗菌药物，专人随访，统计抗菌药物使用率和手术部位感染率，分析、比较不同术式的妇科清洁手术中的抗菌药物使用率。结果18个月中共有1291例妇科清洁手术，年龄为12～75岁，平均（34．46±8．45）岁；人院后从未使用抗菌药物者908例，占70．33％，手术前或（和）手术后使用抗菌药物者383例，占29．67％；术后手术部位感染（盆腔内感染）1例，占0．77‰；腹腔镜手术、开腹手术和腹肇手术3组的抗菌药物使用率，差异无统计学意义。结论不同术式的妇科清洁手术中，绝大多数可以不使用任何抗菌药物而不增加术后感染的风险。OBJECTIVE To evaluate the safety and feasibility of free perioperative antibacterials in the cases with gynecological aseptic operations, and offer the proof of evidence based on medicine for the clinical practice. METHODS All case of gynecological aseptic operations within a certain period in the hospital were included as study objects. The antibacterials were used according to ＂The Principle of Guideline with Clinical Application of Antibaeterials＇, and all cases were followed up by the special staffs. The use rate of antibacterials and the infection rate of operative site were calculated, and the usage rate of antlhaeterlals applied among the groups with different operative pathway were analyzed and compared. RESULTS There were 1291 cases of gynecological aseptic operations in 18 months, aged between 12 and 75 with the mean age of （34.46±8.45）. 908 cases （70.33%） had never used antibiotics after the hospitalization, 383 cases （29. 67%） had used antibiotics before and after the operation, the surgical site infection （pelvic infection） was occurred in 1 case （0. 77‰）, The usage rates of antibacterials among the 3 groups of lapar0scopy, laparotomy and operation of abdominal wall were not significantly different. CONCLUSION The antihacterials are not necessary in the majority of gynecological aseptic operations, otherwise the risks of postoperative infection will can be increased.

关 键 词：清洁手术 抗菌药物 合理用药 

分 类 号：R978.1[医药卫生—药品]