基层医院胃肠手术围手术期预防性应用抗菌药物的调查研究

目的调查我院胃肠外科手术患者围手术期抗菌药物预防使用现状，进一步推动围手术期预防用药合理化。方法对210例Ⅰ类与Ⅱ类手术切口患者围手术期抗菌药物预防性使用情况进行回顾性调查。蛄果208例患者使用了抗菌药物，术前50min、术前2h及术后预防使用抗茵药物者分别占6．75％，15．94％，79．55％。喹诺酮类药物使用率最高，其次是三代头孢菌素类、青霉素类；术后单用、二联、三联应用抗茵药物的比例分别为66．85％，25．48％，7．8g％。I类切口平均用药时间为5．56d，≤5d者59例（29．52％）；Ⅱ类切口平均用药时间为7．15d，≤5d者19例（25．55％）。结论基层医院胃肠外科普遍采用抗菌药物预防手术感染，但严格按围手术期预防用药原则应用者少，必须加强抗菌药物围手术期应用的管理。

Study on the rational application of perioperative antimicrobial agents in surgery

Objective To investigate the current status of the perioperative antimicrobial prophylaxis in a hospital and facilitate rational perioperative antimicrobial administration. Methods Perioperative antimicrobial prophylaxis was retrospectively studied in 210 cases with type I and II incision. Results Antibiotics was used in 208 patients. Prophylactic antimicrobial administration 30 min before operation,2 hours before operation and postoperation accounted for 6.73%,13.94% and 79.33% respectively. Quinolones were used most frequently,cephalosporins were the second,then were penicillins. 66.83%of patients received single antibiotics treatment,and 25.48%and 7.69% of all patients received 2 and 3 kinds of antibiotics combined therapy respectively. The mean antimicrobial course was 5.56 days in type I incision with 39 cases（29.32%） no more than 3 days and 7.15 days in type II incision with 19 cases （25.33%） no more than 3 days. Conclusion Perioperative antimicrobial application can prevent surgical wound incisional infection,it is essential to standardize perioperative antimicrobial application.