神经外科患者584例围手术期抗菌药物临床应用分析

目的:抗菌药物的临床应用是神经外科手术的重要环节之一,我们分析我院神经外科围手术期抗菌药物应用并进行临床讨论。方法:对我院2011年584例神经外科患者抗菌药物专项点评病例资料进行回顾性总结分析,从抗菌药物品种选择、用药时机、疗程、联合用药、费用等指标进行分析比较。结果:在584例Ⅰ～Ⅲ类切口手术患者中,抗菌药物预防性用药为578例次(98.97%),累计用药698例次,平均每例应用1.20次。术前2h给药者240次例(41.96%),用药时间(7.02±3.23)d,所用药物涉及10大类35种,第1、2代头孢菌素,头霉素在Ⅰ、Ⅱ类切口手术中列前3位。抗菌药物主要为单用,二联用药48例(8.28%),无三联用药。不良反应发生率为3.01%(21/698)。结论:我院神经外科手术围手术期患者预防用抗菌药物仍存在一定不规范,需进一步采取相关措施加以干预。

Application of antibiotics in 584 patients scheduled for neurosurgery during perioperative period

Objective: To evaluate the status of application of antibiotics in patients scheduled for neurosurgery during perioperative period.Methods: Medical records of 584 neurosurgery patients in our hospital in 2011 were analyzed retrospective1y in respect of selection of antibiotics,medication time,treatment course,drug combination and drug expenditure,etc.Results: Among the 584 neurosurgery patients,perioperative prophylactic application of antibiotics accounted for 98.96%(578 cases) with a total of 698 times of drug application.The frequency of antibiotics usage was 1.20 times.240 cases(41.96%) received antibiotics 2 hours before the operation.Mean medication duration was(7.02±3.23) days.10 categories and 35 kinds of antibiotics were used in perioperative period.The top 3 drugs for type I and II incision operation were the first-generation and second-generation cephalosporins and cephamycins.Antimicrobial agents were mainly applied alone,but combination of 2 kinds of drug was found in 48 cases(8.28%),no combined use of 3 kinds of antimicrobial drugs was found.Incidence of adverse reaction was 3.01%(21/698).Conclusion: The results show that irrationa1 use of perioperative prophylactic antibiotics is common in neurosurgery,and standardized intervention measures are needed in this regard.