剖宫产患者围手术期预防性应用抗菌药物分析

目的:分析我院剖宫产围手术期抗菌药物预防应用现状,找出存在的问题及原因,促进抗菌药物预防性应用的合理性。方法:依据卫生部出台的相关政策,根据调查目的,设计调查评价表。调出我院2010年1-12月剖宫产手术者的临床资料,按统一标准筛选符合条件的病历共188份,采用调查表项目进行调查、分析及评价。结果:188例剖宫产手术患者全部使用了抗菌药物,均为预防性用药,占100%。品种选择不当65例,占34.6%,所有剖宫产患者均在术前0.5～2h开始用药,平均用药天数5.25d,术后用药时间过长182例,占96.8%。结论:剖宫产产妇围手术期抗菌药物预防性应用存在不合理之处,主要表现在预防用药品种级别过高、预防用药时间过长。临床药师应按《剖宫产手术围手术期预防用抗菌药物管理实施细则》及时与临床医师沟通,加强干预,以减少耐药菌的产生、减轻患者经济负担、提高合理用药水平。

Investigation of Perioperative Antibacterial Drug Used for Prophylaxis in Hospitalized Patients Undergoing Cesarean Operation

Objective. To analyze the application of anti-bacterial drug in postoperative period of cesarean operation, to find the existed problems and reason, then facilitating the reasonable preventive application of anti-bacterial drug. Methods：To make the investigation and the valuation of microbial use for prophylaxis in perioperative patients from the policies of Ministry of Public Health. To find all the cases of cesarean section patients of this hospital during January to December in 2010. There are 188 cases consistent with requirement. To investigate, analyze and value these cases in standardization. Results： All caesarean-operation patients had used the anti-bacterial drug. The irrational use of antibacterials is 65 cases （34. 6 %）, all patients received antibiotics within 2 hours before operation. The average duration of antibiotics usage was 5.25 days, and 182 cases （96. 8~） used the antibacterials for long time. Conclusion： The cesarean section perioperative prophylactic use of antibiotics there is unreasonable, mainly manifested in high rate of irrational antibiotics usage, long duration of antibiotics prophylaxis. The clinical pharmacist shall timely communication with the clinical doctor upon the 《Cesarean operation in perioperative period of the preventive use of antibacterials in management implementation details》, so as to strengthen the inteHerence. Only in the way, the bacterial resistance and high medical cost should be reduced, and achieve rational use of antibacterial.