肝胆外科Ⅱ类切口围手术期预防性抗菌药物使用调查分析  

Antibiotic prophylaxis during perioperative period of type Ⅱ incision surgery in department of hepatobiliary surgery

作　　者：杨晶[1] 柴明珍[1] 张蕾[1] 涂平安[1] 程传苗[1] 

机构地区：[1]第二军医大学东方肝胆外科医院感染办,上海200438

出　　处：《中华医院感染学杂志》2013年第21期5275-5276,5279,共3页Chinese Journal of Nosocomiology

基　　金：上海申康医院发展中心临床管理优化基金资助项目(SHDC2010619)

摘　　要：目的了解肝胆外科Ⅱ类切口手术围手术期抗菌药物预防性使用合理性,确保患者围术期住院安全。方法随机抽取2011年4月Ⅱ类切口手术患者569例,回顾性统计分析Ⅱ类切口围手术期抗菌药物预防使用率、使用强度、抗菌药物使用量排名等指标,综合分析围手术期抗菌药物应用的合理性。结果抗菌药物预防性使用率为100.0%,其中单联用药占14.2%,二联用药占85.8%;围手术期抗菌药物预防使用平均天数为5.5d,其中≤3d占8.3%,4～7d占61.1%,>7d占30.6%;抗菌药物中头孢菌素类占53.2%,其中头孢菌素二代比例最高,硝基咪唑类占41.6%;非限制类用药占7.4%,限制类用药占92.6%,无特殊类抗菌药作为预防用药。结论肝胆外科Ⅱ类切口围手术期预防使用抗菌药物总体良好,但术后用药时间和抗菌药级别等仍存在不足,需进一步加强监督与干预。OBJECTIVE To understand the rationality of prophylactic use of antibacterial agents during the perioperative period of type Ⅱ incision surgery in department of hepatobiliary surgery so as to ensure the safety of hospital stay. METHODS Totally 569 patients who underwent type Ⅱ incision surgery in Apr, 2011 were enrolled in the hospital, then the indicators including the utilization rate of antibiotics prophylaxis, use intensity, and rank of dosage were statistically analyzed, and the rationality of use of antibiotics during the perioperative period was analyzed. RESULTS The rate of prophylactic use of antibacterial agents was 100.0% ; among all the cases, 14.2% took single drug medication, and 85.8% took two-drug medication; the average duration of prophylactic use of antibiotics during perioperative period was 5.5d, the patients with the duration of prophylactic use of antibiotics no more than 3 days accounted for 8. 3%, the patients with the duration of prophylactic use of antibiotics varying between 4 and 7 days 61.1%, the patients with the duration of prophylactic use of antibiotics more than 7 days 30.6%. Among the antibiotics used, the cephalosporins accounted for 53. 2%, the proportion of the second generation cephalosporins was the highest, nitroimidazoles 41.6%; among all the patients, the patients who used non-restricted antibiotics accounted for 7.4%, the patients who used restricted antibiotics accounted for 92.6 %, and no special antibiotics were used for prophylaxis. CONCLUSION The antibiotics prophylaxis during the per/operative period of type Ⅱ incision surgery in department of hepatobiliary surgery is good in general, but the insufficiency in the duration of postoperative medication or class of antibiotics remains , thus the supervision and intervention should be further intensified.

关 键 词：围手术期 预防 抗菌药物 分析 

分 类 号：R978.1[医药卫生—药品]