体外循环围心脏手术期抗生素应用调查与分析

目的:探讨心脏外科体外循环围手术期预防性应用抗生素的合理性.方法:回顾性调查2002年1月～2003年6月在体外循环下行心脏手术病历101份.统计分析使用抗生素名称、给药途径、用法用量、应用抗生素起止时间、手术类型及切口愈合状况、术后监护等内容.结果:手术切口1期愈合97例,延期愈合4例.围手术期抗生素使用率100%,单一用药30例,占20.27%;二联用药49例,占48.51%,三联用药22例,占21.78%.手术后抗生素应用疗程1～15 d,平均为9 d.其中7d以上用药的96例,占95%.结论:术后用抗生素疗程明显偏长,抗感染药物联用比率偏高,说明抗生素在体外循环心脏手术期的预防性应用中还存在一些问题,有必要规范抗生素的应用.

Study on Antibiotics'' Application During the Perioperation Period of Heart Operation by Extracorporeal Circulation

Objective: To explore the rationalization using antibiotics for prevetion during the perioperation period of heart operation by extracorporeal circulation. Method: 101 cases receiving heart operation by extracorporeal circulation from January 2002 to June 2003 were retrospectively studied. The investigative contents included the name of antibiotic, administration way,dose and dosage,duration of therapy, operative type, condition of incision healing, and guardianship after operation were counted and analysed. Result: The operative incisions of 97 cases healed in first stage with the staying intention in 4 cases. All cases were given antibiotics during the peri-operation period. 30 cases (20. 27% ) were given a single antibiotic. 49 cases (48. 51% ) were given two kinds of antibiotics. 22 cases (21.78% )were given three kinds of antibiotics. Duration of therapy using antibiotics after operation varied from 1 to 15 days, of which, 96 cases (95% ) were treated with antibiotics over 7 days. It was obvious that duration of antibiotic administration after operation was too long. Conclusion: The duration used antibiotic after operation was too long, the frequency of combined anti-infective drugs was too high, these showed that the antibiotic ad ministration in the perioperation period of heart operation by extracorporeal circulation for prevention existed some problems, it was necessary that the antibiotic administration should be standardized.