清洁手术围手术期抗菌药物使用调查分析

目的了解某院清洁手术围手术期抗菌药物预防性使用情况，以加强抗菌药物应用的管理。方法采用回顾性调查方法，对177例清洁手术患者围手术期预防性使用抗菌药物情况进行统计分析。结果177例清洁手术患者预防性使用抗菌药物，绝大部分（165例，93.22%）于术前0.5～2 h给药；给药途径以静脉滴注为主(162例， 91.53%)。在56例手术时间＞3 h的患者中，仅3例（5.36%）于术中追加了一次抗菌药物。仅手术前单用一次抗菌药物者25例（14.12%）；手术后用药3～7 d者67例（37.85%），＞7 d者42例（23.73%），＞48 h～3 d者20例（11.30%）。预防用药共7类20种，头孢菌素类占52.71%（主要为第一、二代头孢菌素），其次是青霉素类28.08%；围手术期抗菌药物以单一用药为主。结论该院在清洁手术预防性使用抗菌药物中存在不合理现象，必须加强对外科医生围手术期抗菌药物合理应用知识的教育和临床用药管理。

Analysis on antimicrobial prophylactic usage in clean surgical operations during perioperative period

Objective To study antimicrobial prophylactic usage in clean period, so as to strengthen the management of antimicrobial usage. Methods surgical operations during perioperative Perioperative antimicrobial prophylac tic use for 177 clean surgical operations were investigated retrospectively and statistically analyzed. Results Among all cases, 165 cases（93.22%） were given antimierobial agents 0. 5 - 2 hours before the operations; 162 （91.53 %） cases were administrated by intravenous drip. Among 56 patients whose duration of operation was longer than 3 hours, 3 patients（5. 36%） received an additional intraoperative antimicrobial dose. Single-dose antimicrobial prophylaxis was given in 25 cases（14. 12%） ; 67 cases（37. 85%） received antimicrobial prophylaxis for 3-7 days after operations; 42 cases （23. 73 %） received antimicrobial prophylaxis for more than 7 days and 20 （11.30 % ） for more than 48 hours. 20 kinds of 7 categories of antimicrobial agents were used in the operations, 52.71 % were cephalosporins （the majority were the first and second generation cephalosporins）, followed by penicillins（28. 08%）. Drugs were used mainly in single dosage. Conclusion Inappropriate usage was found in antimicrobial prophylaxis for clean surgical operations during perioperative period. Education about antimicrobial prophylaxis in perioperation to sur geons must be strengthened and management must be enhanced.