小儿穿孔性阑尾炎病原菌特点及围手术期抗菌药物应用  

Pathogen Characteristics of Perforated Appendicitis in Children and the Perioperative Application of Antibiotics

作　　者：曹松山[1] 段彦彦[1] 裴保方[1] 刘晓玲[1] 陶兴茹[1] 陈海燕[1] 

机构地区：[1]郑州市儿童医院药学部,郑州450053

出　　处：《医药导报》2016年第5期465-468,共4页Herald of Medicine

基　　金：郑州市2014年度"常州四药临床药学科研基金"资助项目(CZSYJJ14004)

摘　　要：目的调查穿孔性阑尾炎患儿病原菌特点及围手术期抗菌药物的使用情况,为围手术期合理应用抗菌药物提供参考。方法回顾性分析郑州市儿童医院普通外科2011年7月—2014年8月出院的穿孔性阑尾炎患儿围手术期抗菌药物应用情况,依据《抗菌药物临床应用指导原则》,结合细菌培养结果,判断抗菌药物使用的合理性。结果 149例患儿中有126例送检炎性分泌物,送检率为84.56%,117例培养出致病菌,检出阳性率为92.86%,感染前3位的细菌依次为大肠埃希菌、铜绿假单胞菌和弗劳地枸橼酸杆菌;穿孔性阑尾炎患儿抗菌药物使用率为100.00%,联合用药主要以头孢菌素类和硝咪唑类为主;合理应用抗菌药物144例(96.64%),手术前均应用抗菌药物。结论小儿穿孔性阑尾炎主要致病菌为大肠埃希菌,对临床常用的抗菌药物有较高的敏感性,药敏试验结果对抗菌药物的选择及治疗方案的调整有指导作用。Objective To investigate the pathogen characteristics of perforated appendicitis in children and the perioperative use of antimicrobials in order to provide evidence for the rational use of perioperative antibiotics. Methods The perioperative usage of antibiotics was analyzed to determine the reasonableness of antimicrobial use in children with perforated appendicitis who were discharged from July 2011 to August 2014,based on“guidelines of clinical use of antibiotics”and results of bacterial culture. Results Inflammatory secretions obtained from 126 children（126/ 149）were sent for examination and the examination rate was 84.56%.A total of 117 cases were found positive for cultured pathogens,and the detection positive rate was 92.86%.Three types of bacteria ranking the first three places were Escherichia coli,Pseudomonas aeruginosa and CitroBacter freundii.The utilization rate of antibacterial agents was 100.00%,with a dominant use of cephalosporins and nitrate imidazoles. Rational use of antimicrobial agents was found in 144 cases（accounting for 96.64%）. Conclusion The major pathogen in perforated appendicitis is still Escherichia coli,which is highly sensitive to commonly used antibiotics,and drug-sensitivity testing results can help guide the treatment programs and antibiotics selection.

关 键 词：抗菌药物 阑尾炎 穿孔性/小儿 病原菌 围手术期 

分 类 号：R978[医药卫生—药品] R969.3[医药卫生—药学]