摘要
目的了解Ⅰ类切口围手术期抗菌药物的使用情况,为医院制定围手术期抗菌药物应用管理措施提供依据,提高预防性应用抗菌药物的合理性。方法回顾性调查2012年5月-2013年5月600例Ⅰ类切口手术病例,分析其抗菌药物预防性使用情况,采用SPSS17.0进行统计分析。结果 600例Ⅰ类切口手术患者中256例在围手术期预防性使用了抗菌药物,抗菌药物使用率为42.7%,使用最多的药物是第一、二代头孢菌素,分别占47.7%和44.1%;在使用抗菌药物的256例病例中术前30min^2h给药的235例,占91.8%,术前>2h给药的5例占1.9%,术中追加用药1例占0.4%,术后当天给药的1例占0.4%,术后>1d给药的3例占1.2%;总用药持续时间<24h59例占23.0%、24~48h54例占21.1%、48~168h107例占41.8%、>168h36例占14.1%。结论抗菌药物的用药指征、给药时机、持续用药时间等存在不合理现象,表现为无指征用药、预防用药使用率偏高、抗菌药物选择不合理、首次给药时机不合理、术后用药持续时间过长等,提示Ⅰ类切口手术围手术期预防性使用抗菌药物仍有待进一步规范。
OBJECTIVE To investigate the perioperative prophylactic antibacterial use in type I incision surgery and to provide evidence for formulating management measures for perioperative antibacterial use so as to improve the rationality of prophylactic use of antibacterials .METHODS Totally 600 cases of type Ⅰ incision surgery from Jun . 2012 to May 2013 were retrospectively investigated .The status of antibacterial use in these cases was analyzed . The software SPSS17 .0 was used for statistical analysis .RESULTS Among the 600 cases of type I incision surger‐y ,256 cases used prophylactic antibacterials during the perioperative period which accounted for 43 .7% ,the most used antibacterials were the first and the second generations of cephalosporin which accounted for 47 .7 and 43 .7%respectively .Among the 256 cases using antibacterials ,235 cases used prophylactic antibacterials at 30 min-2 h before surgery ,5 cases at more than 2 h before surgery ,1 case during surgery ,1 case at the same day of surgery and 3 cases at one day later after surgery which accounted for 91 .8% ,1 .9% ,0 .4% ,0 .4% and 1 .2% respective‐ly .Fifty‐nine cases had the medication duration of less than 24 h ,54 cases 24~48 h ,107 cases 48~168 h ,36 cases more than 168 h ,which accounted for 23 .0% ,21 .1% ,41 .8% ,14 .1% respectively .CONCLUSION The use indications of antibacterials ,medication timing and medication duration remained unreasonable ,which were manifested as using antimicrobial with no indications ,the high use rate of prophylactic antibacterials ,the unrea‐sonable selection of antibacterial types ,unreasonable timing for the first dose of medication and long duration of antibacterial use after surgery ,suggesting that the perioperative prophylactic antibacterial use in type I incision surgery still remains to be further standardized .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第23期5826-5827,5830,共3页
Chinese Journal of Nosocomiology
基金
广东省医学科研基金资助项目(A2008232)
关键词
Ⅰ类切口手术
围手术期
抗菌药物
调查
Type Ⅰ incision surgery
Perioperation
Antibacterials
Survey
