急诊科Ⅰ类切口手术围手术期使用抗菌药物的调查分析

摘要

Objective?To analyze the application status and rationality of the antimicrobial agents with emergencyⅠincision during perioperative period, so as to provide some more evidences rational antibiotic usage and standard antibiotic administration. Methods Combining the prospective and retrospective method, 213 orthopedics patients with emergencyⅠincision were chosen from Jun to December 2011. The data of antibiotic usage was analyzed. Result The ratio of antibiotic usage with emergencyⅠincision was 100.00%;drug combination usage was 59.6%. The use frequencies were the first generation cephalosporin 24.3%, quinolone 20.2%, and the third generation cephalosporin 16.2%. 21.1%(45 patients) of antibiotic usage was 2 hours before the surgery, 26.3%(56 patients) was 2 hours after the surgery, and 49.8%(106 patients) of antibiotics by orthopedics patients use no antibiotic before the surgery. Conclusion The prophylactic use of antibiotics by orthopedics patient with emergencyⅠincision has high rate of utilization, inappropriate choice, improper medication timing and long treatment time, etc. So, the management of antibiotic usage should be strengthened, and promote the rational use of drugs.%目的：了解急诊科Ⅰ类切口手术围手术期抗菌药物的应用现状及合理性，为加强抗菌药物合理使用和规范管理提供依据。方法采用前瞻性与回顾性相结合的方法，调查医院2011年6月至12月急诊科Ⅰ类切口手术213例，并对数据进行统计、分析。结果Ⅰ类切口手术抗菌药物预防用药率达100.0%，联合用药率59.6%。使用频率居前三位的依次为一代头孢菌素24.3%、喹诺酮20.2%、三代头孢菌素16.2%。术前≤2h用药有45例，占21.1%；术前＞2h用药56例，占26.3%，术前未用药106例，占49.8%。结论存在抗菌药物使用率高、选择不当、用药时机不恰当、时间过长等现象。应加强急诊科Ⅰ类切口围手术期抗菌药物应用的管理和监督，促进临床医师合理用药。