我院2014年Ⅰ类切口手术围术期抗菌药物预防应用分析  

Analysis of Perioperative Prophylactic Use of Antibiotics for Type Ⅰ Incision Operation in Our Hospital in 2014

作　　者：王绚[1] 许静[1] 徐进[1] 

机构地区：[1]南京医科大学附属南京儿童医院,江苏南京210008

出　　处：《儿科药学杂志》2016年第11期32-35,共4页Journal of Pediatric Pharmacy

基　　金：南京医科大学科技发展基金面上项目;编号2015NJMU068

摘　　要：目的:了解我院Ⅰ类切口手术围术期预防应用抗菌药物的情况,为提高合理用药水平及巩固抗菌药物专项整治活动成果提供可持续改进措施。方法:采用等间隔抽样调查的方法,从我院2014年Ⅰ类切口手术出院患儿病历中随机抽取1 416份,回顾性调查分析围术期预防用药的情况。结果:331例手术围术期预防性使用了抗菌药物,使用率为23.38%(331/1 416);所用抗菌药物主要涉及头孢菌素类、头霉素类、β-内酰胺酶抑制剂类、糖肽类、氧头孢烯类、碳青霉烯类,其中以五水头孢唑林钠为主(46.22%,153/331),其次为头孢呋辛(19.94%,66/331);88.52%(293/331)的病例在术前30 min^2 h使用,84.59%(280/331)用药时间≤48 h;55.89%(185/331)用药不合理,主要表现为预防用药疗程过长、给药时机不适宜、抗菌药物选择不适宜、用法用量不适宜、无指征用药。结论:我院Ⅰ类切口手术预防应用抗菌药物存在不合理现象,应持续改进医疗质量管理,促进抗菌药物的合理使用。Objective： To investigate the perioperative prophylactic application and rational use of antibiotics in type I incision operation in our hospital,and to provide persistent intervention measures for special rectification activities of antibiotics. Methods：Retrospective analysis was performed to investigate perioperative prophylactic application of antibiotics in 1,416 cases with type I incision surgery in our hospital during 2014. Results： The perioperative prophylactic application rate of antibiotics was 23. 38%. The prophylactic application of antibiotics were mainly cephalosporin,cephamycin,β-lactamase inhibitors,glycopeptides,oxacephem,carbapenems. Cefazolin sodium pentahydrate as the main prevention drugs used in 153 cases（ 46. 22%）,followed by cefuroxime（ 19. 94%） in 66 cases. The rate of antibiotics within 30 minutes to 2 h before operation was 88. 52%,and 84. 59% of antibiotic treatment was finished within 48 h after operation. The unreasonable drug use rate was 55. 89%,including unreasonable administration time,long duration of antibiotic treatment,unreasonable antibiotics selection,unreasonable usage and dosage and no indication in drug use. Conclusion： There is still existed unreasonable prophylactic application of antibiotics for type Ⅰ incision operation,so it is necessary to further strengthen the management and continuously promote the rational use of antibiotics in the clinic.

关 键 词：Ⅰ类切口手术 围术期 抗菌药物 合理用药 

分 类 号：R969.3[医药卫生—药理学]