术后预防性抗菌药物使用的调查分析  

Investigation and analysis of improper use of postoperative prophylactic antibiotics

作　　者：沈丽娟[1] 丁卫华[1] 支彩英[1] 章静[1] 

机构地区：[1]杭州市第一人民医院手术室,浙江杭州310006

出　　处：《中华医院感染学杂志》2014年第15期3696-3697,共2页Chinese Journal of Nosocomiology

摘　　要：目的正确掌握术后抗菌药物使用时间及抗菌药物种类,并采取相应对策,减少菌群失调及二重感染,从而降低医院感染率。方法调查2012年9-12月800例普外科住院手术患者术后抗菌药物使用资料,将其随机分为对照组与试验组,各400例;对照组使用抗菌药物种类及时间不限制,试验组使用的抗菌药物种类及时间均有严格的控制。结果对照组400例患者中手术后有350例患者使用两种抗菌药物,50例使用3种抗菌药物,试验组400例患者均预防性使用1种抗菌药物;对照组患者最终导致菌群失调10例、二重感染6例,感染率为4.0%;试验组患者最终引起菌群失调1例、二重感染1例,感染率为0.5%。结论手术后预防性使用抗菌药物的给药时间过长或多种联合使用导致菌群失调比例上升,并且使细菌耐药性增加,出现二重感染,从而增加医院感染率。OBJECTIVE To correctly understand the length of time and variety in the postoperative use of antibiotics, take appropriate care measures to reduce flora imbalance and superinfection, so as to reduce the rate of nosocomial infection. METHODS Data of postoperative antibiotic usage for 800 inpatients in general surgery department from Sept. to Dec. 2012 were investigated. Patients were divided into two groups, the control group and the experimental group, with 400 patients in each group. The variety and use time of antibiotics in the control group were not restricted, but were strictly controlled in the experimental group. RESULTS In the control group, 350 in 400 patients used two kinds of antibiotics, 50 used three kinds of antibiotics; in the experimental group, 400 patients used only one kind of antibiotics. Antibiotics usage resulted in flora imbalance in 10 cases and superinfection in 6 cases in the control group, with an infection rate of 4.0%, and resulted in flora imbalance in 1 and superinfection in 1 in the experimental group with an infection rate of 0.5 %. CONCLUSION Postoperative prophylactic antibiotic use for too long time or combined use with several antibiotics leads to increased percentage of floral imbalance, bacterial resistance and superinfection, and hence increases the risk of nosocomial infections.

关 键 词：抗菌药物 联合使用 时间过长 术后感染率 

分 类 号：R978.1[医药卫生—药品]