2016—2022年上海市56家医疗机构心血管特殊诊疗操作围术期抗菌药物预防应用状况  

Prophylactic use of antibiotics for cardiovascular special intervention procedures during perioperative period in 56 medical institutions of Shanghai from 2016 to 2022

作　　者：王鹏[1] 史庆丰 高晓东 胡必杰 沈燕 WANG Peng;SHI Qing-feng;GAO Xiao-dong;HU Bi-jie;SHEN Yan(The First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830054,China;不详)

机构地区：[1]新疆医科大学第一附属医院感染管理科,新疆乌鲁木齐830054 [2]复旦大学附属中山医院感染管理科,上海200032 [3]复旦大学附属中山医院感染病科,上海200032

出　　处：《中华医院感染学杂志》2025年第2期276-280,共5页Chinese Journal of Nosocomiology

基　　金：上海申康医院发展中心市级医院诊疗技术推广及优化管理项目(SHDC22024315);上海市加强公共卫生体系建设三年行动计划(GWVI-2.1.1GWVI-13)。

摘　　要：目的 调查上海市二级甲等及以上医院开展心血管特殊诊疗操作围手术期抗菌药物(PAP)使用情况,为进一步规范合理使用抗菌药物提供理论依据和数据支持。方法 回顾性收集上海市2016-2022年56所医院开展心血管特殊诊疗操作患者围术期相关数据,对PAP使用情况、用药类别、用药合理性及用药天数等进行统计学分析。结果 本研究共纳入5 172例行心血管特殊诊疗操作患者,血管术、主动脉内支架植入术、下腔静脉滤器植入术、先天性心脏病封堵术、心脏射频消融术的PAP使用率分别为16.60%、16.10%、23.71%、84.85%、16.67%。五类心血管特殊诊疗操作中,先天性心脏病封堵术的PAP总使用率、术前使用率、术中带入率、术后使用率均为最高,分别为84.85%、84.51%、85.75%、84.36%。用药类型共包括80个品种18个类别,以二代头孢和三代头孢的使用率最高。术后24 h抗菌药物停药率为73.71%,心脏射频消融术术后24 h抗菌药物停药率均<40%。结论 上海市二级甲等及以上医院开展心血管诊疗操作存在PAP使用率较高,用药的品种选择不合理,术后预防使用时长上过长等不合理现象。今后应加强此类诊疗操作的PAP管理,为进一步提升上海市整体抗菌药物规范化使用提供有效保障。OBJECTIVE To investigate the perioperative antibiotics prophylaxis(PAP)for the cardiovascular special intervention procedures in two-A or above hospitals of Shanghai so as to provide theoretical bases and data support for further normalizing the use of antibiotics.METHODS The perioperative related data were retrospectively collected from the patients who received the cardiovascular special intervention procedures in 56 hospitals of Shanghai from 2016 to 2022.The status of PAP,classes of drugs,rationality of drug administration and number of medication days were statistically analyzed.RESULTS A total of 5172 patients who underwent cardiovascular special intervention procedures were enrolled in the study.The utilization rate of PAP was 16.60%for vascular surgery,16.10%for aortic stent implantation,23.71%for inferior vena cava filter implantation,84.85%for congenital heart disease occlusion,16.67%for cardiac radiofrequency ablation.The total utilization rate of PAP,preoperative utilization rate,intraoperative infusion rate and postoperative utilization rate of the congenital heart disease occlusion were the highest among the five types of cardiovascular special intervention procedures,which were 84.85%,84.51%,85.75%and 84.36%,respectively.There were totally 18 categories covering 80 types of drugs,and the utilization rates of the second and third generations of cephalosporins were the highest.The withdrawal rate of antibiotics was 73.71%after the surgery for 24 hours,the withdrawal rate of antibiotics was less than 40%after the cardiac radiofrequency ablation for 24 hours.CONCLUSIONS The utilization rate of PAP is high among the patients who receive the cardiovascular intervention procedures in the two-A or above hospitals of Shanghai,and there are unreasonable phenomena such as unreasonable choice of types of drugs and overlong time of prophylactic use of antibiotics after surgery.It is necessary to strengthen the management of PAP for the diagnosis and treatment procedures so as to effectively guarantee the normal

关 键 词：心血管诊疗操作 介入性操作 围术期 预防用药 感染控制 

分 类 号：R978.1[医药卫生—药品]