贵州省Ⅰ类切口手术预防使用抗菌药物现状调查研究  

Investigation on prophylactic use of antibiotics for clean incision surgery in Guizhou Province

作　　者：赵华叶 张家兴[1] 李莲华[1] 钱鑫[1] 严春宏[1] 陈琦[1] 高玲[1] 谢娟[1] Zhao Huaye;Zhang Jiaxing;Li Lianhua;Qian Xin;Yan Chunhong;Chen Qi;Gao Ling;Xie Juan(Department of Pharmacy,Guizhou Provincial People’s Hospital,Guiyang 550002,Guizhou,China.)

机构地区：[1]贵州省人民医院药剂科,贵州贵阳550002

出　　处：《贵州医药》2020年第8期1189-1191,共3页Guizhou Medical Journal

基　　金：北京医卫健康公益基金会项目(编号:YWJKJJHKYJJ-B17444)。

摘　　要：目的调查贵州省二级及以上医疗机构Ⅰ类切口手术预防使用抗菌药物情况,为促进贵州省抗菌药物的合理使用提供基线证据。方法基于贵州省药事管理质量控制中心,采用"调查表"形式回顾性调查全省二级及以上医院的Ⅰ类切口手术预防使用抗菌药物情况,对其围术期抗菌药物的预防性应用进行调查分析。结果共调查了全省86家医院,随机抽取Ⅰ类切口手术患者8 600例,其中有3 232例预防性使用抗菌药物,抗菌药物的使用率为37.58%,三级医院(31.75%)低于二级医院(40.40%);Ⅰ类切口手术抗菌药物使用合理率为37.84%,三级医院(45.89%)高于二级医院(34.78%);对不合理原因进行分析,23.30%的Ⅰ类切口手术无适应症使用抗菌药物,三级医院(4.68%)低于二级医院(18.62%)。给药次数、药物选择、单次剂量错误是影响抗菌药物不合理使用的重要因素。结论贵州省86家医疗机构的Ⅰ类切口手术预防用抗菌药物不合理现象仍较突出,需进一步完善抗菌药物临床应用管理有效措施和长效工作机制,以促进抗菌药物的合理使用。Objective To investigate the prophylactic use of antibiotics for clean incision surgery in Guizhou Province and provide evidence for improving rational use of antibiotics. Methods Based on the quality control center of Guizhou pharmaceutical administration, the study was conducted by questionnaire investigating the prophylactic use of antibiotics for clean incision surgery in Guizhou Province and the statistical analysis was performed. Results this survey included 86 hospitals and 8600 patients who were randomly selected for clean incision surgery.The proportion of prophylactic use of antibiotics(PPUA) for clean incision surgery was 37.58%. The PPUA of the tertiary hospitals was lower than that of the secondary hospitals(31.75% vs 40.40%). The proportion of prophylactic rational use of antibiotics(PPRUA) for clean incision surgery was 37.84%. The PPRUA of the tertiary hospitals was higher than that of the secondary hospitals(45.89% vs 34.78%). The main reason of irrational use was prophylactic use of antibiotics without indication(23.30%), and this reason was more common in the secondary hospitals compared to the tertiary hospitals. In addition, the other reasons for irrational use of antibiotics included inadequate dosage, inappropriate selection of antibiotics, and wrong frequency of administration. Conclusion The situation of irrational use of antibiotics for clean incision surgery in 86 hospitals in Guizhou Province is still serious. It is necessary to improve and strengthen the management of antibiotics and develop a long-term mechanism to guide the rational use of antibiotics.

关 键 词：Ⅰ类切口手术 抗菌药物 预防使用 

分 类 号：R453[医药卫生—治疗学]