剖宫产围手术期一代头孢菌素预防用药干预分析  

Prophylactic use of first generation cephalosporin during perioperative period of cesarean sections

作　　者：王湘[1,2] 荣昆[1,2] 

机构地区：[1]天津市海河医院感染管理科,天津300350 [2]天津市海河医院妇产科,天津300350

出　　处：《中华医院感染学杂志》2013年第22期5522-5524,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解剖宫产围手术期抗菌药物使用与手术切口感染现状,提高临床合理用药水平,控制切口感染。方法采用回顾性调查方法对2010年1月-2012年5月某三级综合医院366例剖宫产手术围手术期预防用药品种、用药时间、联合用药等及发生医院感染情况进行分析比较。结果干预后预防用药品种选择一代头孢的比例提高了22.0%,达到86.4%(P<0.01);干预后联合用药的比例降至12.4%,较干预前降低了50.0%(P<0.01);干预后与使用单剂预防的比例提高了7倍,达到65.0%(P<0.01);24~48h的比例下降了10.1%~6.8%(P<0.01);>48h的不合理用药从10.6%降至0(P<0.01);干预后手术部位感染率由1.1%降至0.6%,差异无统计学意义。结论剖宫产围手术期预防用药干预后对规范的依从明显改善,手术部位感染未见增加。OBJECTIVE To understand the current status of use of antibiotics during perioperatlve period ot cesarean sections and the incidence of surgical incision infections so as to improve the reasonable clinical use of antibiotics and control the incision infections. METHODS A retrospective survey was conducted to analyze the types of prophylactic antibiotics, medication duration, combination use of antibiotics,and incidence of nosocomial infections of 366 cases of patients who underwent cesarean sections in a three A hospital from Jan 2010 to May 2012. RESULTS After the implementation of interventions, the proportion of the cases using first generation cephalosporins reached to 86.4%, with an increase of 22.0 % （P〈0. 001）, the proportion of the cases receiving combination use of antibiotics decreased to 12.4%, with a decrease of 50.0~ （P^0.01） ; the proportion of the cases using single dose of prophylaxis reached to 65. 0%, 7 times higher than that before the interventions （P〈 0. 01）; the proportion of the cases with the treatment course between 24 and 48 hours droped to 638%, with a decease of 10.1% （P〈0.01）; the proportion of the cases with the unreasonable medication duration more than 48 hours decreased from 10.6% to 0 （P〈0. 01） ; the incidence rate of surgical site infections decreased from 1. 1% to 0.6%, the difference was not significant. CONCLUSION After the implementation of interventions, the compliance to the standards of antibiotic prophylaxis during the perioperative period of cesarean sections was impnved without increase in the incidence of surgical site infections.

关 键 词：剖宫产 抗菌药物 围手术期 预防用药 手术部位感染 

分 类 号：R978.1[医药卫生—药品]