目的：了解外科清洁手术预防应用抗菌药物的合理性，为规范围术期用药和临床干预提供依据。方法：通过医院电子信息平台，采用临床观察方法，实时查阅临床病历，收录和跟踪登记解放军264医院（以下简称“我院”）2014年1—6月份256例清洁切口手术患者围术期预防用抗菌药物等情况。对其用药品种、用药时机、用药时间、联合用药情况、手术切口甲级愈合率和院内感染情况进行分析。结果：256例患者有152例未使用抗菌药物，104例使用抗菌药物，总使用率为40.63％。用药时间分布为术前0.5～2 h内用药68例，占65.38％，术后用药＜24 h，16例，为15.38％，超过72 h，20例，为19.23％。用药指征合理性占78.85％，药物品种选择合理性为75.96％。手术切口甲级愈合例数为244例，愈合率为95.31％；切口发生感染2例，为0.78％。结论：该医院清洁切口围术期抗菌药物应用比较规范，院内感染率小于1.5％，符合有关规定。但还存在用药时机不当，用药起点高，时间过长等不合理问题。%OBJECTIVE:To investigate the rationality of prophylactic application of antibiotics for cut cleaning in perioperative surgery , and to provide reference for the regulation of perioperative administration and clinical intervention . METHODS: The hospital electronic information platform and method of clinical observation was adopted , the prophylactic application of antibiotics for cut cleaning in perioperative surgery in 256 patients in the 264 th Hospital of PLA(hereinafter referred to as “our hospital”) from Jan.to Jun.2014 were recorded, registered and precisely tracked . Analysis was conducted on drug varieties , administration occasion , administration days , combination therapy , Class-A healing rate and nosocomial infection .RESULTS:Of the 256 cases, 152 cases didn't use antibiotics and 104 cases did;the total application rate was 40.63%.The distribution of medication time within 0.5-2 h before surgery was 68 cases, accounting for 65.38%;the postoperative medication that <24 h was 16 cases , accounting for 15.38%;the medication time that more than 72h was 20 cases, accounting for 19.23%.The rationality of medication indications was 78.85%, and the rationality of drug categories selection was 75.96%.The number of Class-A healing incision was 244 cases , the healing rate was 95.31%;2 cases had incision infection , accounting for 0.78%.CONCLUSIONS: The prophylactic application of antibiotics for cut cleaning in perioperative surgery was fairly standard , the nosocomial infection rate was less than 1.5%, which conforms to the relevant regulations .But there are still some irrational problems like improper administration occasion , high starting point of administration and overtime administration , etc.
展开▼
