抗菌药物专项整治对乳腺手术围术期预防性使用抗菌药物的影响  

The Effect of Antibacterials Special Rectification on The Prophylactic Use of Antibiotics in The Perioperative Period of Breast Surgery

作　　者：王丽[1] 董雪[1] 李林楷[1] 杨富恒 许慧芳[1] WANG Li;DONG Xue;LI Lin-kai;Yang Fu heng;XU Hui-fang(Zhuhai Maternal and Child Health Hospital,Zhuhai Guangdong 519000,China)

机构地区：[1]珠海市妇幼保健院

出　　处：《抗感染药学》2019年第12期2065-2069,共5页Anti-infection Pharmacy

基　　金：珠海市科技计划医疗卫生项目（编号：20181117E030087)

摘　　要：目的:调查与分析抗菌药物整治前后乳腺癌手术围术期患者抗菌药物预防使用的相关因素及其效果。方法:采用回顾性调查方法,利用医院HIS系统抽取2010年第4季度(整治前)及2012年第4季度、2014年第4季度、2016年第4季度和2018年第4季度(整治后)乳腺良、恶性肿瘤患者手术病例901例资料,分析其围术期抗菌药物使用的合理性。结果:901例乳腺手术围术期患者中,预防用药率、用药时机、药品品种选择等方面基本趋于合理;抗菌药物预防使用率由整治前100.00%降至整治后14.16%;预防用药时机合理率由整治前0.00%上升至整治后100.00%;药品品种选择整治后也更趋于合理,均选用第1代头孢菌素,但预防用药疗程整治后24 h内停药的比例仍然高于40.00%。结论:经抗菌药物专项整治,乳腺手术围术期患者预防用药不合理的现象得到显著改善,但在使用时间等方面仍需加大干预力度,以确保用药的合理性。ABASTRACT Objective:To investigate and analyze the related factors and effects of antimicrobial prophylaxis in perioperative patients with breast cancer before and after antibiotic remediation.Methods:Retrospective investigation was conducted to collect data of 901 patients with benign and malignant breast tumors in the fourth quarter of 2010(before the treatment),2012,2014,2016 and 2018(after the treatment)by using the hospital’s HIS system.The rationality of the use of antibiotics during the perioperative period was analyzed.Results:In the 901 cases of breast surgery,the rate of prophylactic drug use,the timing of drug use,and the selection of drug varieties were basically reasonable.The utilization rate of antibiotics decreased from 100%before treatment to 14.16%after treatment.The reasonable rate of timing of prophylactic medication increased from 0.00%before treatment to 100.00%after treatment.The selection of drug varieties after treatment also tends to be more reasonable and the first generation cephalosporins were selected,but the proportion of drug withdrawal within 24 hours after treatment course of preventive drugs was still higher than40.00%.Conclusion:The special regulation of antibacterial drugs significantly improved the unreasonable phenomenon of drug use in breast surgery patients during perioperative period;however the use of time and other aspects still need to increase the intensity of intervention to ensure the rationality of drug use.

关 键 词：抗菌药物 乳腺癌 乳腺手术 围术期 预防用药 

分 类 号：R969.3[医药卫生—药理学]