316 例肿瘤手术患者预防应用抗菌药物的情况分析

目的调查某院肿瘤患者围手术期预防应用抗菌药物的合理性，为抗菌药物的合理应用和管理提供依据。方法回顾性调查分析2012年7月～2013年6月某院316例肿瘤手术患者的病历资料，按抗菌药物在围手术期预防应用指南等相关标准，对围手术期抗菌药物预防性应用的合理性进行评价。结果I类切口手术抗菌药物预防性使用率为63．0％，Ⅱ类切口手术抗菌药物预防性应用率92．4％；其中使用频度最高的是头孢哌酮舒巴坦钠；用药疗程24～48h（感染率536％），3～7d（感染率4．69％），〉7d（感染率19．57％），用药疗程一周以内术后的感染率无显著性差异（P〉0．05），使用一周以后感染率显著高于一周内（P〈0．05）。主要存在的问题有：预防用药指征把握不严、药物选择不当、用药时机不对、术后用药时间较长、用法用量不合理等。结论某院肿瘤患者围手术期抗茵药物预防应用仍存在不合理现象，需制定完善的围手术期预防用药管理措施，确保安全合理用药。

Analysis of the Use of Prophylactic Antibacterial Agents of 377 Cases of Tumor Surgery Patients

Objective To investigate the rationality of perioperative prophylactic use of antibacterial agents for tumor patients in a hospital, and offer evidence for reinforcing the rational use and standard management of antibacterial agents. Methods Ac- cording to the application guide of prophylactic antibacterial agents in perioperative period and the relevant standards, the medical records of 316 patients with tumor surgery between July 2012 and June 2013 were retrospectively reviewed and analyzed, and their application rationality of antibacterial agents in perioperative period were evaluated. Results The utilization rate of preven- tive antibacterial agents is 63.0% in the patients with type I incision, and is 92.4% in the patients with type ]1 incision. Among those antibacterial agents, the frequency of use of cefoperazone sulbactam is the highest. The percent of infection after operation in 24 - 48 h, 3- 7 d and 〉7 d group were 5.36%, 4.69% and 19.57% respectively. No difference of infection percents was found between 24 - 48 h and 3 - 7 d group （P〉0.05）. The percent of infection in 〉7 d group was higher than in 24 - 48 h or 3 - 7 d group （P〈 0.05）. The main problems such as not confirming medication indicator, improper drug selection, inappropriate time of initial administration, prolonged application, irrational use in dosage and administration exist in the perioperative prophylactic use of antibacterial agents. Conclusion There were unreasonable applications of preventive antibacterial agents to patients of tumor surgery perioperation period. It is suggested to intensify supervision and regulate the rational use of antibacterial agents.