某医院眼科2018-2019年Ⅰ类切口预防性使用抗菌药物调查分析  

Investigation and Analysis of Perioperative Prophylactic Use of Antimicrobial Drugs for Type Ⅰ Incisions in the Opthalmology Department in a Hospital in 2018-2019

作　　者：黄际薇[1] 姜彩云[1] HUANG Jiwei;JIANG Caiyun(Pharmacy Department,The Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院药剂科,广东广州510630

出　　处：《清远职业技术学院学报》2022年第1期48-52,共5页Journal of Qingyuan Polytechnic

基　　金：广东省临床用药研究基金(兴齐眼药专项基金)项目“临床药师参与眼科Ⅰ类切口手术预防用药的作用”(2019XQ12);广东省自然科学基金项目“载蛋白纳米粒的PLGA及其衍生物活性微球的释药机制研究”(2017A030313897);广东省医院药学研究基金(澳美基金)项目“红细胞膜防生姜黄素纳米粒递药系统用于改善炎症的研究”(2021A14);广东省临床用药研究基金(新晨舒适化医疗专项基金)项目“丙泊酚联合芬太尼与瑞马唑仑联合芬太尼麻醉用于胃肠镜检查的成本分析”(2020XC121)。

摘　　要：[目的]观察和分析眼科Ⅰ类切口围手术期预防使用抗菌药物的情况,为制定抗菌药物相关的管理制度提供相应的依据,进一步促进医生合理使用抗生素。[方法]采用回顾性的调查方法,选取2018年1月至2019年12月眼科Ⅰ类切口围手术期病例作为观察、分析的群体。采用随机的选择原则,每月选择5%眼科出院病人数,统计全身和局部抗生素的使用情况。[结果]眼科围手术期入选病例127例,共有29类眼科手术。全身预防性使用抗菌药物7例(5.51%),头孢呋辛选用率最高。给药途径包括静脉给药(6例)和口服给药(1例)。局部预防使用抗菌药物120例(94.49%),庆大霉素31例(24.41%),万古霉素14例(11.02%),红霉素27例(21.26%)。红霉素为点眼置于结膜囊,万古霉素和庆大霉素主要为冲洗。[结论]该医院眼科Ⅰ类切口围手术期患者使用抗生素预防感染以局部为主。不合理用药主要包括无需全身用药、药物品种选择不当、首次给药时机不适宜、用药疗程过长、无依据交替换药等问题,有待进一步规范。[Objective]Observation and analysis of perioperative prophylactic use of antimicrobial drugs for type I incisions in the opthalmology department to provide evidence for antibacterial drug management system,and to promote the clinical rational use of antimicrobial agents.[Method]By a retrospective survey,patients in the perioperative period of type I ophthalmic incision from January 2018 to December 2019 were selected as the analysis group.According to the principle of random selection,the number of patients discharged from the ophthalmology department was selected at 5%per month,and the use of systemic and local antimicrobial drugs was counted.[Result]A total of 127 patients with 29 kinds of ophthalmic operations were included in the perioperative period.In 7 cases of systemic prophylactics,the utilization rate was 5.51%,and cefuroxime was the highest.There were 6 cases of intravenous administration and 1 case of oral administration.There were 120 cases of topical prophylactics,and the utilization rate was 94.49%.Gentamycin was used in 31 cases(24.41%),vancomycin in 14 cases(11.02%)and erythromycin in 27 cases(21.26%).Erythromycin was used as the focal point for conjunctival sac,vancomycin and gentamycin were mainly used for flushing.[Conclusion]Local administration was the main way of perioperative prophylactic use of antimicrobial drugs for type I incisions in the opthalmology department of the hospital.The irrational prophylactic use of antimicrobial drugs mainly included unnecessary systemic drug use,improper selection of drug varieties,inappropriate time of first administration,excessively long duration of drug use,unwarranted alternating administration and other problems,which should be further standardized.

关 键 词：眼科 抗菌药物 预防性用药 围术期 Ⅰ类切口 合理用药 

分 类 号：R969.3[医药卫生—药理学]