围手术期抗菌药物预防应用前瞻性调查

目的了解和分析医院围手术期抗菌药物应用情况。方法对某三级教学医院2005年6-12月手术病例共2055例次进行前瞻性调查。结果2055例次中,抗菌药物使用率99.95%,其中清洁、清洁-污染、污染手术抗菌药物使用率分别为99.92%、100.00%、100.00%;一、二、三联抗菌药物使用分别占72.47%、25.84%、1.12%;围手术期抗菌药物使用时间平均为8.16d,清洁、清洁-污染、污染手术平均抗菌药物使用分别为8.1、8.2、8.2d;术前0.5~2h使用抗菌药物占29.65%,术后使用抗菌药物占68.00%;清洁手术和清洁-污染手术术后使用抗菌药物<48h者仅占3.45%;抗菌药物使用种类依次为头孢三代、头孢二代、青霉素等;手术切口感染率0.75%,其中清洁、清洁-污染、污染手术切口感染率分别为0.29%、1.33%、3.42%。结论围手术期抗菌药物使用不规范,用药时机、药物选择不合理,用药时间持续过长,围手术期抗菌药物规范化使用亟待重视和解决。

Application of Prophylactic Antibiotics During Perioperative Period

OBJECTIVE To investigate and analyze the application of prophylactic antibiotics in perioperative period in hospital.METHODS Totally 2 055 cases under operation were investigated prospectively from Jun to Dec in 2005.RESULTS The rate of antibiotics usage was 99.95% among the 2 055 cases.The usage of antibiotics in aseptic wound was 99.92%,and in aseptic-contaminative and contaminative wound was all 100%;72.47% of the patients received single antibiotic treatment,25.84% and 1.12% received 2 to 3 kinds of antibiotics combined therapy respectively.The mean time of the usage of antibiotics during perioperative period was 8.16 days,and that for aseptic,aseptic-contaminative and contaminative wound was 8.1,8.2,and 8.2 days,respectively.29.65% Patients were given antibiotics in 0.5-2 hours before operation,68% were given after operation.The duration of antibiotics therapy less than 48 hours was only 3.45%.The rate of wound infection was 0.75% in patients. The rate of wound infection of aseptic,aseptic-contaminative and contaminative operations was 0.29%,1.33% and 3.42%,respectively.CONCLUSIONS Application of prophylactic antibiotics during perioperative period in hospital is not reasonable.The problem is improper time that given antibiotics,improper kind of antibiotics selected and too long duration of the antibiotics therapy.It is necessary that the antibiotics administration should be standardized.