水城县人民医院213例Ⅰ类切口手术围术期预防性应用抗菌药物合理性分析

目的：了解我院Ⅰ类切口手术围术期预防性应用抗菌药物情况,并对其使用合理性进行评价,为临床合理使用抗菌药物提供参考。方法：收集2011年1月—2012年11月我院213份Ⅰ类切口手术病历进行统计、分析。结果：213例Ⅰ类切口患者,其中专项整治活动前有53例,抗菌药物预防性使用率为96.23%;20例患者联合用药,占39.22%,其中有2例患者为三联用药;给药时间正确的仅1例,占1.96%;使用的抗菌药物品种为9种,多为第3代头孢菌素,甚至选用头霉素类头孢西丁。专项整治活动后有160例,抗菌药物预防性使用率为43.13%;8例患者二联用药,占11.59%,无三联或四联用药;给药时间正确的有26例,占37.68%;使用的抗菌药物品种为9种,其中头孢菌素类占5种,使用最多的为第1代头孢菌素头孢唑林。结论：专项整治活动后,我院Ⅰ类切口手术围术期预防性用药较之前有很大改观,但不合理应用现象依然存在,主要表现为给药时间不当,使用时间过长及无指征用药。

Rationality of Perioperative Use of Prophylactic Antibiotics for Patients Undergoing Type I Incision Operation in Shuicheng County People＇ s Hospital： Analysis of 213 Cases

OBJECTIVE ： To analyze the perioperative use of prophylactic antibiotics for patients undergoing type I incision operation in our hospital and evaluate its rationality so as to provide reference for clinical rational use of antibiotics. METHODS： A total of 213 medical records of patients undergoing type I incision operation in our hospital from Jan. 2011 to Nov. 2012 were analyzed statistically. RESULTS： Of the 213 cases, 53 were cases before the initiation of special rectification activity, with 96. 23% used prophylactic antibiotics, 39.22% （20 cases） used drugs in combination, and 2 cases used three drugs in combination; only 1 case （1.96%） had correct time of drug administration; 9 types of antibiotics were used, mostly the third generation cephalosporins or even cefoxitin （cephamycins） that was used. There were 160 cases after the initiation of special rectification activity, with 43.13 % used prophylactic antibiotics, 8 cases （ 11.59% ） used two drugs in combination, and none used three or four drugs in combination; 26 cases （37.68%） had correct time of drug administration; 9 types of antibiotics including 5 cephalosporins were used, mostly cefazolin （the first generation cephalosporins）. CONCLUSION：After the initiation of the special rectification activity, the perioperative use of prophylactic antibiotics for patients undergoing type I incision operation in our hospital showed great improvement yet the irrational use of drugs still existed which manifested as improper time of administration, prolonged administration duration and non-indication administration.