江苏省中医院319例Ⅰ类切口手术围术期预防性应用抗菌药物合理性分析  

Analysis of Perioperative Use of Prophylactic Antibiotics in Patients Undergoing TypeⅠIncision Operation in Jiangsu Provincial Hospital of Traditional Chinese Medicine:Analysis of 319 Cases

作　　者：付虹[1] 邱召娟[1] 张小萍[1] 

机构地区：[1]江苏省中医院药学部临床药学室,南京210029

出　　处：《中国医院用药评价与分析》2013年第3期227-230,共4页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:了解我院Ⅰ类切口手术围术期预防性应用抗菌药物情况,为医院管理部门制订相应管理措施提供科学依据。方法:采用回顾性调查方法,对2011年6—12月我院出院的319例Ⅰ类切口手术患者围术期预防性应用抗菌药物情况进行统计分析。结果:319例Ⅰ类切口手术患者中有306例预防性应用了抗菌药物,其中241例使用了第1代头孢菌素,占78.76%;32例使用了β-内酰胺类+β-内酰胺酶抑制剂复方制剂,占10.46%;15例使用了氟喹诺酮类抗菌药物,占4.90%。107例术前0～2 h使用抗菌药物,占34.97%;185例术后用药,占60.45%。54例按照说明书规定的剂量使用抗菌药物,占17.65%。结论:Ⅰ类切口手术预防性应用抗菌药物存在不合理,主要表现为指征把握不严、使用率过高、种类选择不合理、超说明书用药、使用时间不当及疗程过长。今后应进一步加强Ⅰ类切口手术围术期预防性应用抗菌药物的监督和管理。OBJECTIVE ：To investigate the perioperative use of prophylactic antibiotics in patients undergoing type I incision surgery in our hospital so as to provide scientific reference for relative management department in making management measures. METHODS： By a retrospective study, the medical records of 319 patients undergoing type I incision operation in our hospital who were discharged during Jun. -Dec. period of 2011 were analyzed statistically with regard to the perioperative use of prophylactic antibiotics. RESULTS：Of the 319 cases reviewed,306 used prophylactic antibiotics, with first-generation cephalosporins used in 241 （78.76%） ,β-1actam plus β-1actamase compound agents in 32 （10. 46% ） and Quinolones in 15 （4.90%）. 107 （34.97%） used antibiotics 0-2 h before operation and 185 （60. 45% ） after operation. 54 （17.65%） used antibiotics as per the dosage specified in drug package inserts. CONCLUSION ：The perioperative use of prophylactic antibiotics in patients undergoing type I incision surgery was irrational in some aspects, which manifested as loose mastering of indications, high rate of antibiotic use, irrational choice of drug types, off-label use, improper time of administration and prolonged use of antibiotics, h is urgent to strengthen monitoring and management on the perioperative use of prophylactic antibiotics in patients undergoing type I incision surgery.

关 键 词：Ⅰ类切口手术 抗菌药物 预防性用药 围术期 

分 类 号：R978.1[医药卫生—药品]