2018年荆门地区10家医院剖宫产围术期预防用抗菌药物的合理性分析

目的 对2018年荆门地区10家医院剖宫产围术期预防用抗菌药物的合理性进行分析，加强荆门地区医院剖宫产围术期预防性抗菌药物的合理使用与管理。方法 回顾性抽取荆门地区2018年10家医院（三级综合医院4家，二级综合医院3家，专科医院3家）剖宫产手术患者病历968份，对围术期抗菌药物的品种选择、首剂给药时机、给药疗程和联合用药情况进行统计分析。结果 参与调查的10家医院抗菌药物使用率均达100%，品种选择合理率三级医院79.5%，二级医院75.4%，专科医院87.8%；首剂给药时间三级医院和专科医院均在脐带结扎后，二级医院69.4%在脐带结扎后，30.6%在术后给药；平均给药疗程三级医院为2.7 d，二级医院为3.5 d，专科医院为2.3 d。抗菌药物的使用大部分为单用，但也存在少数患者有二联用药，无三联使用抗菌药物的情况。结论 荆门地区医院剖宫产围术期抗菌药物品种的选择趋于合理，用法用量逐步规范合理，但首剂给药时机和用药疗程仍存在不合理之处。

Analysis on reasonable use of prophylactic antibacterial drugs in perioperative period of cesarean section in 10 hospitals of Jingmen area in 2018

Objective To analyze the reasonable use of prophylactic antibacterial drugs in perioperative period of cesarean section in 10 hospitals of jingmen area in 2018, and to strengthen the rational use and management of prophylactic antibiotics in perioperative period of cesarean section in hospital of jingmen area. Methods 968 Medical records of patients underwent external abdominal hernia surgery were collected from 10 hospitals of jingmen area (4 third-level hospitals, 3 second-level hospitals, and 3 specialized hospitals retrospectively). The utilization of antibiotics was analyzed statistically in respect of antimicrobial species, timing of initial dose, and average treatment course. Results The utilization ratio of antibiotics was 100% in the 10 hospitals. The reasonability of type selection of antibiotics was 79.5% in third-level hospitals, 75.4% in second-level hospitals, and 87.8% in specialized hospitals. The timing of initial dose was administered after the umbilical cord ligation in third-level hospitals and specialized hospitals, 69.4% was administered after the umbilical cord ligation in second-level hospitals, and 30.6% was administered after the postoperative. The average treatment course was 2.7, 3.5, and 2.3 d. The use of antibiotics was mostly single use, but there were also a few patients who had two combinations of antibiotics and no three combinations of antibiotics. Conclusion The type selection of antibiotics in perioperative period of cesarean section from the hospitals of jingmen area tends to be scientific, and the usage and dosage are gradually standardized and reasonable, but the timing of initial dose and drug treatment are still unreasonable.