某院120例Ⅰ类切口围手术期预防用抗菌药物分析

目的了解某三级甲等医院I类切口手术围手术期抗菌药物预防应用情况。方法随机抽取该院2012年1月至12月I类切口择期手术患者病历共120份进行相关分析。结果120例I类切口手术围手术期抗菌药物预防应用中抗菌药物使用率为40. 83%，抗菌药物品种选择合格率为91.84%，以单一用药为主，涉及4个品种，给药时机为术前0.5 ~2 h的占67. 35% ,术后未用药和疗程不超过 48h的占87. 75%。结论该院的I类切口围手术期抗菌药物预防应用基本符合要求，但仍需加强抗菌药物临床应用培训管理工作。

Hs-CRP,Hcy and carotid atherosclerosis in advanced age patients with coronary artery disease and atrial fibrillation

Objective：To observe the changes of high sensitivity C reactive protein（hs-CRP）,homocysteine（Hcy）and carotid atherosclerosis in advanced age patients with coronary artery disease（CAD）and atrial fibrillation（Af）.Method：Patients over 80years diagnosed as CAD according to angiography were classified as Af group of 105patients with Af history and sinus thythem group of 91patients without Af history.The 84age-matched subjects without Af history and CAD were as control group.The Af group was subdivided into paroxysmal Af, persistent Af and permanent group Af as well.The levels of hs-CRP and Hcy were measured by automatically biochemistry and carotid artery ultrasound was used to detecte the carotid intima-media thickness（IMT）and the Crouse scores of plaque.Result：The levels of hs-CRP and Hcy in Af group were significantly higher than those in the sinus group and control group（P0.05）.Besides,those levels in permanent Af group were still higher than those in persistent Af group,and both of which higher than those in paroxysmal Af group（P0.05）,demonstrating the level of hs-CRP and Hcy increased gradually following with duration of Af.In addition,IMT and the Crouse scores of plaque in Af group were significantly higher than those in sinus group and control group（P 0.05）,which were higher in permanent Af group than in persistent Af group,and both of which higher than those in paroxysmal Af（P0.05）,indicating carotid atherosclerosis aggravation with the duration Af.Conclusion：The advanced age patients with CAD and Af were combine with inflammation,oxidative stress and carotid atherosclerosis as well,and are worse with duration of Af.