林芝地区322例清洁手术围手术期预防应用抗菌药物调查  

Investigation on prophylactic use of antibiotics during perioperative period in 322 cases of clean-up operation in Linzhi area

作　　者：易燕桃 郭梅红 张均 YI Yan-tao;GUO Mei-hong;ZHANG Jun(Department of Clinical Pharmacy,Zhaoqing Second People’s Hospital,Zhaoqing 526060,China)

机构地区：[1]肇庆市第二人民医院临床药学科,526060 [2]林芝市人民医院药学部,860000

出　　处：《中国现代药物应用》2019年第14期152-154,共3页Chinese Journal of Modern Drug Application

摘　　要：目的了解林芝地区清洁手术(也称Ⅰ类切口手术)围手术期抗菌药物的预防使用情况,为规范抗菌药物的使用提供依据。方法回顾性分析本院2018年1~9月322例清洁手术的临床资料,对其围手术期抗菌药物使用情况进行统计分析。结果林芝地区322例清洁手术抗菌药物预防使用率为72.98%(235/322),以白内障手术、开颅血肿清除手术、骨折内固定术的抗菌药物预防使用率排列前三。235例清洁手术预防用药时机不合理主要表现在两个方面:一是术前≥2.0 h的有83例(35.32%),白内障手术占了95.18%(79/83);二是术后的有36例(15.32%),骨折内固定术占了58.33%(21/36)。235例清洁手术预防用药维持时间:未用的有112例(47.66%),白内障手术占了70.54%(79/112);>24 h的有79例(33.62%),骨折内固定术占了81.01%(64/79)。大部分清洁手术选择预防性应用抗菌药物,以第一、二代头孢菌素为主,占64.26%(151/235);其次是青霉素类,占23.40%(55/235);在剂型选择上,白内障手术选择阿莫西林舒巴坦匹酯片、头孢地尼分散片口服给药,占33.62%(79/235);其他手术均选择注射剂型给药,占66.38%(156/235)。结论林芝地区清洁手术围手术期预防性使用抗菌药的用药指征、用药时机、用药持续时间等存在不合理现象,提示清洁手术围手术期预防性使用抗菌药物仍有待进一步规范。Objective To understand the prophylactic use of antibiotics during perioperative period of cleaning operation(also known as type Ⅰ incision operation) in Linzhi area, and to provide basis for standardizing the use of antibiotics. Methods The clinical data of 322 cases of clean-up operation in our hospital from January to September 2018 were retrospectively analyzed, and the use of antibiotics in perioperative period was analyzed. Results The prophylactic use rate of antibiotics in 322 cases of clean-up operation in Linzhi area was 72.98%(235/322), with prophylactic use rate of antibiotics in cataract surgery, craniotomy hematoma removal surgery and fracture internal fixation as the top three. The inappropriate timing of preventive medication in 235 cases of cleanup surgery was mainly manifested in two aspects:83 cases(35.32%) was before operation ≥2.0 h, with cataract surgery accounting for 95.18%(79/83);36 cases(15.32%) was after operation, with fracture internal fixation accounting for 58.33%(21/36). Duration of prophylactic drugs in 235 cases of clean operation:112 cases(47.66%) were unused, with cataract surgery accounting for 70.54%(79/112), 79 cases(33.62%) were > 24 h, with fracture internal fixation accounting for 81.01%(64/79). Prophylactic use of antibiotics was the main choice in most clean operations, with the first and second generation cephalosporins accounting for 64.26%(151/235), followed by penicillins accounting for 23.40%(55/235). Amoxicillin sulbactam pivoxil tablets and cefdinir dispersible tablets were used orally in cataract surgery, accounting for 33.62%(79/235), while injection was used in other operations, accounting for 66.38%(156/235). Conclusion There are some unreasonable phenomena in the indication, timing and duration of prophylactic use of antibiotics in perioperative period of clean-up operation in Linzhi area, which indicates that the prophylactic use of antibiotics in perioperative period of clean-up operation still needs to be further standardized.

关 键 词：林芝地区 清洁手术 围手术期 抗菌药物 预防用药 

分 类 号：R95[医药卫生—药学]