某综合医院神经外科围手术期抗菌药物合理性分析  

Rationality analysis of perioperative antibiotics in neurosurgery of a general hospital

作　　者：窦欲晓 胡学锋 许健[2] DOU Yuxiao;HU Xuefeng;XU Jian(Pharmacy Department of the Eighth People's Hospital of Hefei,Hefei,Anhui 238000,China)

机构地区：[1]合肥市第八人民医院药剂科,安徽合肥238000 [2]蚌埠医学院第一附属医院药剂科,安徽蚌埠233004

出　　处：《中华全科医学》2023年第10期1686-1688,共3页Chinese Journal of General Practice

基　　金：安徽省教育厅重点项目(KJ2021A0801)。

摘　　要：目的评价合肥市第八人民医院神经外科围手术期预防性使用抗菌药物的适宜性。方法利用医院信息系统,随机选取2022年1—12月神经外科收治的手术患者62例,对其围手术期预防性使用抗菌药物进行评价与分析,主要评价内容包括抗菌药物的选择(一代、二代头孢菌素或头孢曲松,其中一代头孢菌素推荐头孢唑林,二代头孢菌素推荐头孢呋辛)、适应证(建议对接受颅脑手术的患者进行围手术期预防性使用抗菌药物,头皮肿物切除术等不经颅内的神经外科手术不推荐常规使用预防性抗菌药物)、使用剂量、首次预防用药给药时机以及抗菌药物的持续使用时间等。结果62例患者年龄为(65.52±14.31)岁,男性45例(72.58%),女性17例(27.42%);62例患者中,Ⅰ类切口61例(98.39%),Ⅱ类切口1例(1.61%);有7例(11.29%)患者存在不必要的延长术后预防用药持续时间的现象;首次预防用药时机不合理的患者19例(30.65%);预防用抗菌药物无指征的患者7例(11.29%);所有入组患者中,只有29例(46.77%)在所有神经外科围手术期预防使用抗菌药物评价指标中都是合理的。结论合肥市第八人民医院神经外科预防性使用抗菌药物预防切口部位感染存在一些不足,需要进一步加强抗菌药物合理使用的宣传与管理。Objective To evaluate the appropriateness of perioperative prophylactic antibiotic use in neurosurgery department of the Eighth People's Hospital of Hefei.Methods Using the hospital information system,62 surgical patients admitted to the Department of Neurosurgery from January to December 2022 were randomly selected to evaluate and analyze their perioperative prophylactic antibiotic use.The main evaluation contents included the selection of antibiotics(the first and second generation Cephalosporin or Ceftriaxone,of which the first generation Cephalosporin recommended Cefazolin,and the second generation Cephalosporin recommended Cefuroxime),indications(it is recommended to use prophylactic antibiotics in the perioperative period for patients undergoing craniocerebral surgery,and routine use of prophylactic antibiotics is not recommended for Neurosurgery operations without intracranial access such as facial nerve microvascular decompression,scalp Benign tumor resection,etc.),dosage,timing of first prophylactic drug administration and duration of antimicrobial use.Results The age of 62 patients was(65.52±14.31)years,including 45 males(72.58%)and 17 females(27.42%).Among the 62 patients,61 cases(98.39%)had ClassⅠincision and 1 case(1.61%)had ClassⅡincision.Seven patients(11.29%)unnecessarily prolonged the duration of postoperative prophylaxis;19 patients(30.65%)had an inappropriate timing for the first preventive medication;There were 7 patients(11.29%)without indications for prophylactic use of antibiotics;Of all enrolled patients,only 29 cases(46.77%)were appropriate in all the evaluation indicators of perioperative prophylactic use of antibiotics in neurosurgery.Conclusion There are some deficiencies in the prophylactic use of antibiotics to prevent incision site infection in the neurosurgery department of the Eighth People's Hospital of Hefei.It is necessary to further strengthen the publicity and management of rational use of antibiotics.

关 键 词：神经外科 围手术期 抗菌药物 

分 类 号：R978.1[医药卫生—药品] R969.3[医药卫生—药学]