目的：了解骨科Ⅰ类切口手术围术期预防性应用抗菌药物的合理性情况，为规范围术期预防性用药提供参考。方法：采用回顾性调查分析方法，抽取南昌市第三医院（以下简称“我院”）318例骨科Ⅰ类切口手术患者的病历资料，对预防性应用抗菌药物的合理性进行统计分析。结果：我院骨科Ⅰ类切口手术围术期抗菌药物预防性使用率为90.88％（289／318）。289例预防性用药患者中，术前2 h给药率为99.31％（287／289）；抗菌药物选择合理率为98.96％（286／289）；用药疗程合理率为83.04％（240／289）；预防性用药时间＞48 h患者所占比例为14.53％（42／289）；手术时间＞3 h者63例、失血量＞1500 ml者6例（其中上述2种情况同时出现的有2例），仅13例患者术中追加抗菌药物。结论：我院骨科Ⅰ类切口手术围术期抗菌药物预防性使用率较高，预防性用药时间＞48 h患者所占比例也较高，术中追加率偏低，有待今后持续改进。%OBJECTIVE:To investigate the application rationality of prophylactic antibiotics in orthopedics patients with type Ⅰincision , so as to provide reference for the standardization of prophylactic application during perioperative period.METHODS:Retrospective analysis was adopted , the medical records of 318 orthopedics patients with type Ⅰincision were extracted from the Third Hospital of Nanchang ( hereinafter referred to as “our hospital”) , statistical analysis was conducted on the application rationality of prophylactic antibiotics . RESULTS: The prophylactic application rate of antibiotics in type Ⅰ incision was 90.88%( 289/318 ) .Of the 298 patients with prophylactic antibiotics , the rate of administration before operation of 2 h was 99.31%( 287/289 ) , the rational rate of antibiotics selection was 98.96%(286/289), and the rational rate of treatment course was 83.04%(240/289).The percentage of drug duration more than 48 h were 14.53%(42/289).Meanwhile, there were 63 cases with operative time more than 3 h, 6 cases with blood loss more than 1 500 ml(2 cases had both situations), and only 13 cases had the addition of antibiotics during the operation .CONCLUSIONS:The prophylactic application rate of antibiotics in type Ⅰincision of our hospital is relatively high as well as the percentage of drug duration more than 48h;yet the additional rate during operation is relatively low;which still needs to be institutionalized , long-term oriented .
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