腹腔镜胆囊切除术围手术期抗菌药物的使用分析

目的：调查我院普外科腹腔镜胆囊切除术围手术期抗菌药物的使用情况,评价其用药的合理性。方法：随机抽取2011-2013年出院病例639例,对抗菌药物的种类、用药时间、用药比例及药物联用等进行调查与分析。结果：639例中使用抗菌药物的病例有432例。其中,2011年266例,使用率94.5%;2012年173例,使用率75.72%;2013年200例,使用率21.50%。使用抗菌药物的品种有13种,头霉素类最多,头孢菌素类、抗厌氧菌类及酶抑制剂类次之。围手术期用药存在用药疗程过长,个别联合用药欠妥的现象。结论：抗菌药物专项整治后腹腔镜胆囊切除术围手术期抗菌药物使用率降低明显。抗菌药物的选用逐步合理化,但24小时内停药率偏低,医院要继续加强围手术期抗菌药物的应用管理,提高合理用药水平,有效控制细菌耐药,并持续改进。

Analysis of Antibacterials Application During Perioperative Period of Laparoscopic Cholecystectomy

Objective： To investigate the use of antibacterials during the perioperative period of laparoscopic cholecystectomy in our hospital and evaluate the rationality of medication . Methods： About 639 cases of discharged patients from 2011 to 2013 were randomly sampled and the investigation and analysis were carried out on the species of antibacterial drugs , medication time , medicine proportion and combination drug use , etc . Results： Of 639 cases , 432 patients used antimicrobials , among them 266 cases used in 2011 , 173 in 2012 and 200 in 2013 with the using rate of 94 . 5%, 75 . 72% and 21 . 50% respectively . About 13 varieties of antibacterials were applied in treatment , cephamycins was the most frequently used and then were cephalosporins , anti anaerobe and enzyme inhibitors . The medication duration in perioperative period was too long and there was individual cases with unreasonable combination drug use in the treatment . Conclusion： The application rate of antimicrobials during the perioperative period of laparoscopic cholecystectomy reduced obviously after the rectification of antimicrobial drugs . The selection of antimicrobial drugs was gradually rationalized , but it was still hard to stop the drug use within 24 hours . Hospitals should further strengthen the management of antimicrobial application in perioperative period , improve the rational drug use , effectively control bacterial drug resistance , and make a continuous improvement .