360例手术患者围术期抗菌药物预防性应用分析
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摘要
目的:了解首都医科大学密云教学医院手术患者围术期预防性应用抗菌药物情况,促进临床合理使用抗菌药物。方法:对2017—2018年我院上报全国抗菌药物临床应用监测网的360例手术病例进行回顾性分析,依据国家卫生健康委员会的相关规定,对抗菌药物的品种选择、给药时间、用药疗程和联合用药等指标进行评价与分析。结果:360例手术患者中,212例预防性应用抗菌药物,抗菌药物预防性使用率为58.89%;29例治疗性使用抗菌药物;119例未使用抗菌药物。其中,Ⅰ类切口手术围术期抗菌药物预防性使用率为29.17%(35/120),符合相关规定(≤30%);Ⅱ类切口手术围术期抗菌药物预防性使用率为80.82%(177/219);Ⅲ类切口手术治疗性使用抗菌药物21例。头孢菌素类抗菌药物的预防性使用率最高,部分病例药品选择、用药疗程不符合相关规定。结论:我院手术患者围术期抗菌药物的使用仍存在一些问题,需进一步加强抗菌药物的应用管理和药学干预。
ABSTACT OBJECTIVE: To investigate the prophylactic application of antibiotics during perioperative period in Miyun Teaching Hospital Affiliated to Capital Medical University(hereinafter referred to as "our hospital"), so as to promote clinical rational application of antibiotics. METHODS: 360 surgical cases in our hospital during 2017-2018 reported to the Center for Antibacterial Surveillance were retrospectively analyzed, according to relevant regulations of National Health Commission, the cases were evaluated and analyzed in terms of drug selection, drug administration time, treatment course and drug combination, etc. RESULTS: Among the 360 patients, 212 cases were prophylactically applies with antibiotics, with the rate was 58.89%; 29 cases were therapeutically applied with antibiotics; 119 cases were not used antibiotics. Among them, the prophylactic application rate of antibiotics during perioperative period of type Ⅰ incision was 29.17%(35/120), which complied with relevant regulations(≤30%); the prophylactic application rate of antibiotics during perioperative period of type Ⅱ incision was 80.82%(177/219); the number of therapeutic application of antibiotics in type Ⅲ incision was 21 cases. The prophylactic application rate of cephalosporins antibiotics was the highest, the drug selection and treatment course in some cases do not meet the relevant regulations. CONCLUSIONS: There are still some problems in the application of antibiotics during perioperative period, which is necessary to further strengthen its application management and pharmaceutical intervention.
ABSTACT OBJECTIVE: To investigate the prophylactic application of antibiotics during perioperative period in Miyun Teaching Hospital Affiliated to Capital Medical University(hereinafter referred to as "our hospital"), so as to promote clinical rational application of antibiotics. METHODS: 360 surgical cases in our hospital during 2017-2018 reported to the Center for Antibacterial Surveillance were retrospectively analyzed, according to relevant regulations of National Health Commission, the cases were evaluated and analyzed in terms of drug selection, drug administration time, treatment course and drug combination, etc. RESULTS: Among the 360 patients, 212 cases were prophylactically applies with antibiotics, with the rate was 58.89%; 29 cases were therapeutically applied with antibiotics; 119 cases were not used antibiotics. Among them, the prophylactic application rate of antibiotics during perioperative period of type Ⅰ incision was 29.17%(35/120), which complied with relevant regulations(≤30%); the prophylactic application rate of antibiotics during perioperative period of type Ⅱ incision was 80.82%(177/219); the number of therapeutic application of antibiotics in type Ⅲ incision was 21 cases. The prophylactic application rate of cephalosporins antibiotics was the highest, the drug selection and treatment course in some cases do not meet the relevant regulations. CONCLUSIONS: There are still some problems in the application of antibiotics during perioperative period, which is necessary to further strengthen its application management and pharmaceutical intervention.
引文
[1] 国家卫生计生委办公室,国家中医药管理局办公室,总后卫生部药品器材局.关于印发《抗菌药物临床应用指导原则(2015年版)》的通知[S].国卫办医发[2015]43号.2015-07-24.
[2] 赵静,宁美英,等.某院145例围手术期预防应用抗菌药物调查分析[J].药品评价,2013,10(14):30-33.
[3] 卫生部办公厅.关于做好全国抗菌药物临床应用专项整治活动的通知[S].卫办医政发[2011]56号.2011-04-18.
[4] 韩凤,杨明娜,丁寅子,等.2016年北京市海淀区14家二级医院抗菌药物应用分析[J].中国医院用药评价与分析,2018,18(10):1391-1393.
[5] 王桂芝,张丽香,郭宪清,等.577例骨科Ⅰ类切口手术围术期抗菌药物应用统计分析[J].中国伤残医学,2017,25(6):57-58.
[6] 杜佳娣,于海峰,田甜,等.Ⅱ类手术切口患者171例围手术期抗菌药应用分析[J].同济大学学报:医学版,2017,38(1):104-107.
[7] 袁慧龙,刘静.Ⅰ类切口围手术期抗菌药物应用分析[J].医药导报,2017,36(S1):122-123.
[8] 江莉,胡君,欧阳越,等.新版《抗菌药物临床应用指导原则》干预妇产科Ⅱ类切口手术的实施效果[J].中国妇幼保健,2017,32(24):6061-6064.
[9] 吴骏,陈集志.某院外科头孢西丁使用合理性分析[J].东南国防医药,2017,19(2):213-215.
[10] 白雪,杨友运,韩枫,等.会阴侧切术预防性应用抗菌药物效果的系统评价[J].中国医药导报,2018,15(31):146-150.
[11] 王丽琼.预防性抗生素应用于顺产分娩会阴侧切术的临床分析[J].饮食保健,2017,4(16):22-23.
[12] 王欣.某三级医院Ⅰ类切口手术抗菌药物应用情况分析[J].安徽医药,2018,22(10):2022-2026.
[13] 王慧.会阴侧切术预防性应用抗菌药物的疗效观察[J].中国医院用药评价与分析,2016,16(5):601-602.
[14] 刘聚源,李娜,武迎宏,等.清洁手术术中追加抗菌药物对手术部位感染预防控制效果的研究[J].中华医院感染学杂志,2016,26(18):4144-4147.
[15] 刘文东,尚妍.我院全国抗菌药物临床应用监测网直报Ⅰ类切口手术围术期预防使用抗菌药物情况点评分析[J].中国医药科学,2018,8(22):176-179.
[16] 冯燕,李薇,王来成.某院妇科围手术期抗菌药物应用调查分析[J].北方药学,2018,15(9):170-172.
[2] 赵静,宁美英,等.某院145例围手术期预防应用抗菌药物调查分析[J].药品评价,2013,10(14):30-33.
[3] 卫生部办公厅.关于做好全国抗菌药物临床应用专项整治活动的通知[S].卫办医政发[2011]56号.2011-04-18.
[4] 韩凤,杨明娜,丁寅子,等.2016年北京市海淀区14家二级医院抗菌药物应用分析[J].中国医院用药评价与分析,2018,18(10):1391-1393.
[5] 王桂芝,张丽香,郭宪清,等.577例骨科Ⅰ类切口手术围术期抗菌药物应用统计分析[J].中国伤残医学,2017,25(6):57-58.
[6] 杜佳娣,于海峰,田甜,等.Ⅱ类手术切口患者171例围手术期抗菌药应用分析[J].同济大学学报:医学版,2017,38(1):104-107.
[7] 袁慧龙,刘静.Ⅰ类切口围手术期抗菌药物应用分析[J].医药导报,2017,36(S1):122-123.
[8] 江莉,胡君,欧阳越,等.新版《抗菌药物临床应用指导原则》干预妇产科Ⅱ类切口手术的实施效果[J].中国妇幼保健,2017,32(24):6061-6064.
[9] 吴骏,陈集志.某院外科头孢西丁使用合理性分析[J].东南国防医药,2017,19(2):213-215.
[10] 白雪,杨友运,韩枫,等.会阴侧切术预防性应用抗菌药物效果的系统评价[J].中国医药导报,2018,15(31):146-150.
[11] 王丽琼.预防性抗生素应用于顺产分娩会阴侧切术的临床分析[J].饮食保健,2017,4(16):22-23.
[12] 王欣.某三级医院Ⅰ类切口手术抗菌药物应用情况分析[J].安徽医药,2018,22(10):2022-2026.
[13] 王慧.会阴侧切术预防性应用抗菌药物的疗效观察[J].中国医院用药评价与分析,2016,16(5):601-602.
[14] 刘聚源,李娜,武迎宏,等.清洁手术术中追加抗菌药物对手术部位感染预防控制效果的研究[J].中华医院感染学杂志,2016,26(18):4144-4147.
[15] 刘文东,尚妍.我院全国抗菌药物临床应用监测网直报Ⅰ类切口手术围术期预防使用抗菌药物情况点评分析[J].中国医药科学,2018,8(22):176-179.
[16] 冯燕,李薇,王来成.某院妇科围手术期抗菌药物应用调查分析[J].北方药学,2018,15(9):170-172.