剖宫产围手术期预防使用抗菌药物的用药分析

摘要

目的 通过对我院剖宫产手术患者围手术期使用抗菌药物的分析,了解剖宫产围手术期预防应用抗菌药的情况,促进临床合理用药.方法 采用回顾性调查方法,随机抽取我院2012年6月至2013年6月产科剖宫产手术出院病历.对剖宫产围手术期抗菌药物的用药品种、频率、时间、联合用药等情况进行分析.结果 243例剖宫产病例全部使用抗菌药物,使用频率最高的抗菌药物是头孢西丁、头孢唑林.用药持续时间≤48 h有203例(83.5％),用药时间49 ～ 72 h有10例(4.1％),用药时间＞ 72h有30例(12.4％).联合用药主要包括头孢西丁+奥硝唑、头孢唑啉钠+甲硝唑.结论 我院剖宫产患者围手术期抗菌药物的使用基本按照卫生部于2009年3月发布的《卫生部办公厅关于抗菌药物临床应用管理有关问题的通知》(简称38号文件)执行,但仍然存在一些不合理处,主要表现在用药持续时间和药物联合用药的选择方面,医院应该进一步加强围手术期抗菌药物的使用管理.%Objective By analyzing antibiotics application in cesarean section in our hospital,to investigate the prophylactic use of antibiotics in women undergoing cesarean section.Methods Women undergoing cesarean section in obstetrics of our hospital from June 2012 to June 2013 were randomly selected.Medication species,frequency,time,and drug combination of perioperative antibiotics application were analyzed.Results Antibiotics were used in all of the 243 cases of cesarean section.The most frequently used antibiotics were cefoxitin and cefazolin.Duration of drug usage in 203 cases was ≤ 48 h,10 cases 49-72 h,30 cases ＞72 h.Drug combination included cefoxitin + ornidazole and cefazolin + metronidazole.Conclusions Antibiotics application during perioperative period of cesarean section in our hospital were in accordance with No.38 document published by Ministry of Public Health in March 2009,but there were still some unreasonable problems,which were mostly duration of drug usage and selection of drug combination.Management ofperioperative antibiotics application should be further strengthened.