西安市14所医院Ⅰ类手术切口抗菌药物预防性应用分析  

Prophylactic use of antibiotics for typeⅠincision surgery in 14 hospitals in Xi′an

作　　者：潘京京[1] 孙萌[2] 王惠川[1] 胡斌[1] 王静[1] 陈晟[1] 闵慧[1] 李琼阁[1] 

机构地区：[1]西安交通大学附属广仁医院药剂科,陕西西安710004 [2]西安交通大学药学院,陕西西安710061

出　　处：《中华医院感染学杂志》2016年第6期1397-1399,1403,共4页Chinese Journal of Nosocomiology

基　　金：中国博士后科学基金资助项目(2013M530428)

摘　　要：目的了解抗菌药物临床应用专项整治3年以来西安市二级以上医院清洁切口手术围术期预防应用抗菌药物的成效,为合理用药提供依据。方法回顾性调查西安市2011-2013年8所三级医院及6所二级医院出院的Ⅰ类切口手术患者临床资料,对其围术期抗菌药物的预防性应用进行分析、总结;采用SPSS 13.0进行统计分析。结果 3年二级医院及三级医院Ⅰ类切口手术抗菌药物预防使用率分别从87.10%及95.54%下降至39.25%及39.66%;预防应用抗菌药物种类分别涉及11类46种及12类60种;第一、二代头孢菌素使用率分别从31.04%及42.60%上升至69.91%及79.47%;初次给药率在术前30min^2h内的分别从69.96%及62.97%上升至98.09%及87.49%;给药疗程<24h的比例分别由10.52%及12.73%上升至33.01%及40.77%。结论整治活动3年西安市Ⅰ类切口手术预防性应用抗菌药物管理取得显著成效,但仍存在用药疗程偏长等问题,需要进一步加强管理,形成长效机制。OBJECTIVE To understand the effectiveness of perioperative prophylactic use of antibiotics for clean incision surgery in above secondary hospitals in Xi＇an since the special rectification of clinical use of antibiotics was conducted 3years ago so as to provide guidance for reasonable use of antibiotics.METHODS The clinical data were collected from the discharged patients who underwent the typeⅠincision surgery in 8tertiary hospitals and 6secondary hospitals in Xi＇an from 2011 to 2013,then the perioperative prophylactic use of antibiotics was observed,and the statistical analysis was performed with the use of SPSS13.0software.RESULTS During the past 3years,the rate of prophylactic use of antibiotics for the typeⅠincision surgery dropped from 87.10%to 39.25%in the secondary hospitals,and it decreased from 95.54% to 39.66%in the tertiary hospitals.The antibiotics prophylaxis contained 11 categories and 46 types in the secondary hospitals and 12 categories and 60 types in the tertiary hospitals.The utilization rate of the first generation cephalosporins increased from 31.04%to 69.91%in the secondary hospitals and increased from 42.60%to 79.49%in the tertiary hospitals.The rate of initial administration within 30min^2hours before the surgery increased from 69.96% to 98.09%in the secondary hospitals and increased from 62.97%to 87.49%in the tertiary hospitals.The proportion of the patients with the administration course less than 24 hours increased from 10.52% to 33.01% in the secondary hospitals and increased from12.73% to 40.77%in the tertiary hospital.CONCLUSIONThe prophylactic use of antibiotics for the typeⅠincision surgery has achieved significant effectiveness in Xi＇an since the special rectification was conducted three years ago,however,the problems such as long medication course remains;it is necessary to strengthen the management and develop a long-term mechanism.

关 键 词：Ⅰ类手术切口 抗菌药物 预防性应用 合理用药 

分 类 号：R978.1[医药卫生—药品]