广西地区10家三级甲等医院3种清洁手术围术期预防用抗菌药物分析

目的:评价广西地区医院3种清洁手术(甲状腺手术、乳腺手术、疝气修补术)围术期预防用抗菌药物情况。方法:选取广西地区10家三级甲等医院327份清洁手术患者出院病历,根据抗菌药物合理应用评价标准,对其适应证、药物选择、用药时间、溶媒选择、用法用量、联合用药等情况进行统计、分析。结果:327例患者中,有324例应用抗菌药物(占99.08%),其中无指征用药者215例(占66.36%)、用药时机不当者147例(占45.37%)、术后用药时间过长者295例(占91.05%)、预防用药选择不合理者138例(占42.59%)、更换药物无指征者5例(占1.54%)、用法用量不正确者17例(占5.25%)、联合用药不合理者11例(占3.40%)、用药途径不合理者54例(占16.67%)。结论:该地区3种清洁手术围术期预防用抗菌药物不合理用药现象较严重,应采取有效、可行的干预措施,提高抗菌药物合理应用率,降低抗菌药物费用,确保患者用药安全、有效、经济。

Analysis of the Perioperative Prophylactic Application of Antibacterials for 3 Types of Clean Operations in 10 Grade Three Class A Hospitals in Guangxi Area

OBJECTIVE： To evaluate the perioperative prophylactic application of antibacterials for 3 types of clean operations in Guangxi Area. METHODS： 327 patients underwent cleaning operations in 10 Grade Three Class A hospitals of Guangxi area were investigated. According to evaluation standards for rational use of antibiotics, the indication, selection of antibiotics, timing of drug use, proper selection of solvent, usage and dosage, drug combination were analyzed statistically. RESULTS： Among 327 patients, 324 patients underwent clean surgery were treated with antibacterials （99.08%）. The main forms of irrational use of antibacterials were as follows： 215 cases of antibacterials use without indication（66.36% ）, 147 cases of incorrect timing of antibacterials use （45.37%）, 295 cases of long course of treatment （91.05%）, 138 cases of irrational prophylactic drug use （42.59%）, 5 cases of frequently changing drugs without indication （1.54%）, 17 cases of incorrect usage and dosage （5.25%）, 11 cases of unreasonable drug combination （3.40%）, 54 cases of unreasonable route of administration （16.67%）. CONCLUSION： The irrational prophylactic applications of antibiotics for 3 types of clean operations during perioperative period are serious in Guangxi area. Hospital should take effective and feasible measures to improve the rational use of antibacterials, reduce the antibiotics costs, ensure safe, effective and economical drug use of patients.