我院神经外科Ⅰ类切口手术围手术期抗菌药物预防使用情况调查及合理性评价  

Investigation and Rationality Evaluation of Perioperative Prophylactic Application of Antibiotics for Type Ⅰ Incision Operation of Neurosurgery in Our Hospital

作　　者：赵明琴[1] 粟珊[1] 汪明群[1] 陈乾[1] 杨安强[2] 朱必刚[3] ZHAO Mingqin;SU Shan;WANG Mingqun;CHEN Qian;YANG Anqiang;ZHU Bigang(Dept. ofPharmacy,the First People’s Hospital of Yibin,Sichuan Yibin 644000,China;Dept. of Neurosurgery,theFirst People’s Hospital of Yibin,Sichuan Yibin 644000,China;Information Section,the First People’sHospital of Yibin,Sichuan Yibin 644000,China)

机构地区：[1]宜宾市第一人民医院药剂科,四川宜宾644000 [2]宜宾市第一人民医院神经外科,四川宜宾644000 [3]宜宾市第一人民医院信息科,四川宜宾644000

出　　处：《中国药房》2018年第10期1412-1415,共4页China Pharmacy

基　　金：四川省卫生计生委科研课题(No.16PJ587)

摘　　要：目的:为进一步提高神经外科Ⅰ类切口手术围手术期抗菌药物预防使用合理性提供参考。方法:调取我院2016年1-12月神经外科的794例住院行Ⅰ类切口手术患者的病历资料,就其围手术期抗菌药物预防使用情况进行回顾性调查,并进行用药合理性评价。结果:794例神经外科Ⅰ类切口手术患者中,有433例在围手术期预防使用了抗菌药物(均只使用了1种药品),预防使用率为54.53%;使用例数占比居前2位的是头孢唑林(51.73%)和头孢呋辛(21.48%)。433例患者中,于术前30 min^1 h开始用药的占85.45%;用药维持时间≤24 h的占68.36%;主要的2种预防用药不合理情况是预防用药维持时间过长(31.64%)和预防用药品种选择不当(26.10%),此外还有用药时机不当(14.55%)等。结论:我院神经外科Ⅰ类切口手术围手术期抗菌药物预防使用仍存在预防用药品种选择不当、用药时机不当、用药维持时间过长等不合理情况,须采取综合干预措施,促进该领域抗菌药物的合理使用。OBJECTIVE：To provide reference for improving the rationality of perioperative prophylactic application of antibiotics in type Ⅰ incision operation of neurosurgery. METHODS：Medical records of 794 patients with type Ⅰ incision operation of neurosurgery were collected from our hospital during Jan.-Dec. 2016 in order to retrospectively investigate the perioperative prophylactic application of antibiotics and evaluate the rationality of drug use. RESULTS：Among all the 794 cases,433 used antibiotics for prophylaxis（single type was used in all cases）,with utilization rate of 54.53%. Cefazolin（51.73%）and cefuroxime（21.48%）were the most frequently used antibiotics. The prophylactic application rate of 30 min-1 h before surgery was 85.45% in 433 patients. Patients with prophylactic medication course ≤24 h accounted for 68.36%. The main irrational drug use manifestations were long medication time（31.64%）and improper antibiotics selection（26.10%）;other manifestations included improper medication timing（14.55%）,etc. CONCLUSIONS：Unreasonable perioperative prophylactic application of antibiotics in typeⅠincision operation of neurosurgery exists in our hospital,such as improper drug selection,improper medication timing,long medication course. It is necessary to further strengthen the comprehensive interventions,so as to promote the rational use of antibiotics.

关 键 词：神经外科 Ⅰ类切口手术 围手术期 抗菌药物 预防使用 合理性评价 

分 类 号：R978.1[医药卫生—药品] R969.3[医药卫生—药学]