骨科Ⅰ类切口手术预防使用抗菌药物的调查分析  

Investigation of Application of Prophylactic Antibiotics in Orthopedics Type I Incision

作　　者：卓霞[1] 阚燕[1] 闽鹏[1] 

机构地区：[1]成都市第一人民医院,四川成都610016

出　　处：《今日药学》2012年第12期724-727,共4页Pharmacy Today

摘　　要：目的比较国家"限抗令"政策下,本院骨科I类切口手术预防性抗菌药物使用状况的变化。方法回顾性分析本院骨科2010-07～2012-07收治的的2 288例Ⅰ类切口手术患者病历,并按照医院进行抗菌药专项整治活动时点将病例分为2组:2010.7～2011.7为治理前组(A组),2011-08～2012-07为治理后组(B组)。比较2组预防性抗菌药物使用率、抗菌药物品种、用药时机、用药疗程及联合用药情况。结果共收集合格病例2 188份,其中A组1 135份,B组1 053份。在A和B组中有人工植入物的手术比例分别为46.3%和61.4%。A组和B组Ⅰ类切口手术预防性抗菌药物使用率分别为89.8%和65.0%,其中无植入物手术的使用率分别为81.0%和15.5%。用药品种以头孢硫眯、头孢替安、头孢呋辛、头孢曲松为主,该4种药物占所有抗菌药物种类比例在A和B组分别为61.9%和92.0%;术前0.5～2 h内预防用药比例在A和B组分别75%和80%,A和B组平均用药时间分别为(6.8±2.6)d和(2.6±1.3)d;A和B组联合用药率分别为11.2%和1.3%。统计学分析,A和B组相比,Ⅰ类切口手术预防性抗菌药物使用率、用药品种、用药时机、用药疗程、联合用药比例5方面都存在统计学差异(P<0.05)。结论本院在抗菌药物整治后,骨科Ⅰ类切口手术的预防性用药有一定改善,但因近1年来有人工植入物的手术比例大,抗菌药的使用率和疗程与国家标准存在差距,有待进一步改进。Objective To evaluate prophylactic use of antibiotics in orthopedics type I incision in the hospital under the guidance of national principles of antibiotic management.Methods A retrospective analysis was employed to investigate 2 188 cases admitted to orthopaedic surgery with type I incision in the hospital from July 2010 to July 2012.The cases were divided into pre-treatment group（group A） and improving group（group B） evenly,according to the time of national policy activities.Some index were compared between 2 groups,including the rate of prophylactic antibiotics use,varieties of antimicrobial drugs,medication timing,duration of drug treatment and combined treatment.Results 1 135 cases of group A and 1 053 cases of group B were analyzed,and the proportion of artificial implant surgery was 46.3% in group A and 61.4% in group B.89.8% and 65.0% cases in group A and group B were administered with prophylactic antibiotics,respectively,and containing 81.0% in group A and 15.5% in group B among the patients without artificial implant surgery.1st or 2nd generation of cephalosporin such as cefathiamidine,cefotiam,cefuroxime,and ceftriaxone accounted a large proportion in group A（61.9%） and B（92.0%） among all prophylactic antibiotics users.Reasonable rate of medication timing（antibiotics use within 0.5-2 h before operation） in group A and group B were 75% and 80%,respectively.The average treatment time were（6.8 ± 2.6） d and（2.6 ± 1.3） d,and the incidence of antibiotics in combination were 11.2% and 1.3% in group A and B,respectively.There was significant difference in many indexes such as prophylactic antibiotics use,drug varieties,duration of drug treatment,the proportion of combination therapy（P 0.05）.Conclusion The condition of prophylactic application of antibiotics in orthopedics type I incision were improved after antibiotic management,though a large proportion of the artificial implant surgery existed.It needs to take more efforts to reduce the proportion of antimicrobial drug usa

关 键 词：骨科 Ⅰ类切口 预防性用药 抗菌药物 

分 类 号：R969[医药卫生—药理学]