四川基层医院Ⅰ类切口手术预防用抗菌药物调查分析  

Survey and Analysis on Prophylactic Antibacterial Use in patients with Type Ⅰ Incision Operation in Primary Hospitals

作　　者：唐志立 李胜前 陈兴智[2] 杨思芸 李林 

机构地区：[1]四川省南充市中心医院药学部,四川南充637000 [2]四川省营山县人民医院,四川南充637700

出　　处：《中国药业》2013年第10期76-77,共2页China Pharmaceuticals

摘　　要：目的促进医院围术期预防性抗菌药物的合理应用。方法选取四川省10家基层医院289份清洁手术患者出院病历,根据抗菌药物合理应用评价标准,对其适应证、药物选择、用药时间、溶剂选择、用法用量、联合用药等情况进行统计、分析。结果289份病历中,158例使用抗菌药物,使用率为54.67%。其中切皮前30 min～2 h内给药的135例,占85.44%。预防性应用抗菌药物共涉及7类17种,药物联用共160例应用频次排序列前3位的依次为头孢硫脒(42例,26.25%)、头孢西丁(21例,13.13%)、克林霉素(20例,12.50%);单一用药156例(98.73%),二联用药2例(1.27%)。结论抗菌药物临床应用专项整治活动开展后,Ⅰ类切口手术预防应用抗菌药物更规范合理,且单一用药率及初次给药时机的合理性明显上升,但仍然存在使用率偏高、用药种类选择不当及疗程过长等问题,需加强监管。Objective To promote the rationality in perioperative prophylactic application of antibacterials. Methods Two hundred and eighty- nine discharged medical records of clean operations were selected from 10 primary hospitals in Sichuan province and performed the statistical analysis in the aspects of the indication, selection of antibaeterials, medication duration, selection of solvent, usage and dosage,and combination medication. Results Among 258 cases of discharged medical records,158 cases used antibacterials with the use rate of 54.67% ,in which 135 cases （85.44%） received antibacterials at preoperative 30 min-2 h. Seven categories and 17 kinds of antibacteriais were involved. The combination medication was in 160 cases. The top 3 in the list of frequency were cefathiamidine （42 cases, 26.25% ）,cefoxitin （21 cases, 13.13% ） and clindamycin （20 cases, 12.50% ）. A hundred and fifty -two cases （98.73%） received single antibacterial agent and 2 cases （1.27%） received the 2- drug combination. Conclusion After developing the special project rectification campaign of clinical antibacterial drug use, the use of prophylactic antibacterials in the patients undergoing type I incision operations has become more standardized and more rational. The rationality in the use rate of single drug and the initial medication timing is obviously increased. However,the problems such as the higher use rate, improper selection of drug kinds and too long duration of medication course still exist,which need to further strengthen the supervision and management.

关 键 词：Ⅰ类切口手术 抗菌药物 合理用药 

分 类 号：R969.3[医药卫生—药理学] R978.1[医药卫生—药学]