55例胃肠息肉黏膜切除术后预防用抗菌药物的合理性分析  

Analysis on Rationality of Prophylactic Usage of Antimicrobial Agents in 55 Patients with Gastro-intestinal Polyps after Mucosal Resection

作　　者：殷卫清[1] 唐叶秋[1] 范红春[1] YIN Wei-qing;TANG Ye-qiu;FAN Hong-chun(The No.1 People's Hospital of Changshu,Changshu Jiangsu 215500,China)

机构地区：[1]常熟市第一人民医院,江苏常熟215500

出　　处：《抗感染药学》2019年第3期400-404,共5页Anti-infection Pharmacy

摘　　要：目的:分析胃肠息肉黏膜切除术患者术后预防用抗菌药物的合理性及其使用现状,为医院规范侵入性操作过程中抗菌药物的合理使用提供参考。方法:抽取2018年11—12月间收治的内镜下黏膜切除术患者55例病历资料,其中胃息肉6例、肠息肉49例;将其感染高危因素患者分为预防用药组,无感染高危因素患者为非预防用药组,依据《抗菌药物临床应用指导原则:2015版》要求,分析两组患者术前术后炎症因子水平的变化情况和抗菌药物的使用情况。结果:与预防用药组相比,抗菌药物的预防性使用并没有缩短非预防用药组患者的住院时间,也未影响术后体温、中性粒细胞异常的比例;两组患者术后均未发生菌血症、穿孔、腹痛腹泻等并发症,预防用药品种符合率为50.90%,给药时机、疗程均不符合规定。结论:无感染高危因素患者在实施内镜下胃肠息肉黏膜切除术操作中,不必采用抗菌药物预防性用药,医院应采取行政干预,以提高抗菌药物预防使用的合理性。Objective: To analyze the rationality of postoperative prophylactic usage of antimicrobial agents in patients with gastrointestinal polyp after mucosa resection and its current situation, and to provide a reference for the rational use of antimicrobial agents in the process of invasive operation. Methods: Medical records of 55 patients of endoscopic mucosal resection admitted from November to December 2018 were extracted, including 6 cases of gastric polyps and 49 cases of intestinal polyps. The patients with high risk factors of infection were divided into the prophylactic group, and the patients without high risk factors of infection were divided into the non-prophylactic group. According to the requirements of the guidelines for clinical application of antimicrobial agents: 2015 edition, the changes in the levels of inflammatory factors and the use of antimicrobial agents in the two groups before and after surgery were analyzed.Results: Compared with the prophylactic group, the prophylactic use of antimicrobial agents did not shorten the hospitalization time of patients in the non-prophylactic group, nor did it affect the proportion of postoperative body temperature and neutrophil abnormalities. Postoperative complications such as bacteremia, perforation, abdominal pain and diarrhea did not occur in the two groups, and the compliance rate of the prophylactic drugs was 50.90%. Conclusions: In the operation of endoscopic gastrointestinal polypectomy for patients without high risk factors of infection, prophylactic use of antimicrobial agents is not necessary;the hospital should take administrative intervention to improve the rationality of the prophylactic use of antimicrobial agents.

关 键 词：胃肠息肉 内镜诊疗 抗菌药物 合理用药 

分 类 号：R969.3[医药卫生—药理学]