某医院2016年Ⅱ类切口围手术期预防性应用抗菌药物的合理性分析
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摘要
目的分析某医院2016年Ⅱ类切口手术围手术期预防性应用抗菌药物的合理性,为促进合理用药提供参考。方法通过病案系统随机抽取该院2016年1-12月每月出院的15例Ⅱ类切口手术病例(共180例),回顾性分析并评价其预防性应用抗菌药物的合理性。结果 180例Ⅱ类切口手术病例中143例预防性应用抗菌药物,应用率为79.4%。选用的药品主要为注射用头孢唑林钠(45.9%)、注射用头孢呋辛钠(23.6%)、注射用头孢西丁钠(11.4%)和甲硝唑注射液(8.9%)。143例预防性应用抗菌药物病例中,51例存在不合理用药情况(35.7%)。不合理预防性应用抗菌药物的类型依次为用药疗程过长(92.2%)、选药品种不恰当(47.1%)、术前给药时机不合理(31.4%)、联合用药不合理(25.5%)和给药剂量偏大(19.6%)等。结论该医院临床Ⅱ类切口手术围手术期预防性应用抗菌药物存在一定的用药不合理问题,医院及管理部门应加强相关法律法规的实施和监管,提交Ⅱ类切口手术围手术期预防性应用抗菌药物的合理性。
Objective To analyze the rationality of the use of prophylactic antibacterials in the perioperative period of typeⅡ incision surgery in order to improve the rational use of drugs.Methods Fifteeen patients of type Ⅱ incision surgery discharged each month were randomly selected from the medical record system in our hospital in 2014. The rationality of prophylactic use of antibacterials among a total of 180 cases was retrospectively analyzed and evaluated. Results 143 of these cases used antibacterials during the perioperative period,accouting for 79. 4% of the total. The main antibacterial drugs used were cefazolin sodium( 45.9%) for injection,cefuroxime sodium for injection( 23.6%),cefoxitin sodium for injection( 11.4%) and metronidazole( 8.9%). 51 cases of irrational drug use were detected among the 143 cases that used perioperative prophylactic antibacterials( 35.7%). The main problems with the use of antibacterials were the long course of drug treatment( 92.2%),inappropriate types of drugs( 47.1%),wrong time for administration( 31.4%),improper drug combination( 25.5%) and large doses( 19.6%).Conclusion Irrational use of perioperative prophylactic antibacterials for typeⅡ incision surgery is a problem in our hospital. The implementation of relevant laws and regulations and supervision should be enhanced to promote the sound use of prophylactic antibacterials during the perioperative period.
Objective To analyze the rationality of the use of prophylactic antibacterials in the perioperative period of typeⅡ incision surgery in order to improve the rational use of drugs.Methods Fifteeen patients of type Ⅱ incision surgery discharged each month were randomly selected from the medical record system in our hospital in 2014. The rationality of prophylactic use of antibacterials among a total of 180 cases was retrospectively analyzed and evaluated. Results 143 of these cases used antibacterials during the perioperative period,accouting for 79. 4% of the total. The main antibacterial drugs used were cefazolin sodium( 45.9%) for injection,cefuroxime sodium for injection( 23.6%),cefoxitin sodium for injection( 11.4%) and metronidazole( 8.9%). 51 cases of irrational drug use were detected among the 143 cases that used perioperative prophylactic antibacterials( 35.7%). The main problems with the use of antibacterials were the long course of drug treatment( 92.2%),inappropriate types of drugs( 47.1%),wrong time for administration( 31.4%),improper drug combination( 25.5%) and large doses( 19.6%).Conclusion Irrational use of perioperative prophylactic antibacterials for typeⅡ incision surgery is a problem in our hospital. The implementation of relevant laws and regulations and supervision should be enhanced to promote the sound use of prophylactic antibacterials during the perioperative period.
引文
[1]王家玲,薛新建,曹玉.围手术期抗菌药物合理应用调查评估分析[J].中国执业药师,2012,9(2):16.
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[3]赵振寰,马霖,曹玉,等.Ⅰ类手术切口感染率与围手术期预防使用抗菌药物关系探讨[J].中华医院感染学杂志,2011,21(16):3459.
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[6]卫生部,国家中医药管理局.抗菌药物临床应用指导原则[S].卫办医政发[2004]285号.
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[8]张瑞.I、II类切口围手术期抗菌药物预防性应用规范的制定与实施效果监测[J].中国处方药,2015,24(4):41.
[9]赵强.129例Ⅰ类、Ⅱ类切口手术患者围手术期预防用抗菌药物分析[J].中国药业,2012,21(11):38.
[10]蒙光义,罗雪兰,王冬晓,等.外科Ⅱ类切口手术围术期预防应用抗菌药物研究分析[J].中国医院药学杂志,2015,35(2):164.
[11]杨颜霞.某院抗菌药物的不合理使用分析[J].中国处方药,2015,13(9):33.
[2]冉素平,张洪姣,王惠,等.外科围手术期预防应用抗菌药物调查分析[J].中华医院感染学杂志,2012,22(23):5355.
[3]赵振寰,马霖,曹玉,等.Ⅰ类手术切口感染率与围手术期预防使用抗菌药物关系探讨[J].中华医院感染学杂志,2011,21(16):3459.
[4]刘玲玲.我院Ⅰ类切口围手术期预防应用抗菌药物调查分析[J].中国保健营养,2013,24(2):33.
[5]中华医学会外科学分会,中华外科杂志编辑委员会.围手术期预防应用抗菌药物指南[J].中华外科杂志,2006,44(23):1594.
[6]卫生部,国家中医药管理局.抗菌药物临床应用指导原则[S].卫办医政发[2004]285号.
[7]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[S].卫办医政发[2009]38号.
[8]张瑞.I、II类切口围手术期抗菌药物预防性应用规范的制定与实施效果监测[J].中国处方药,2015,24(4):41.
[9]赵强.129例Ⅰ类、Ⅱ类切口手术患者围手术期预防用抗菌药物分析[J].中国药业,2012,21(11):38.
[10]蒙光义,罗雪兰,王冬晓,等.外科Ⅱ类切口手术围术期预防应用抗菌药物研究分析[J].中国医院药学杂志,2015,35(2):164.
[11]杨颜霞.某院抗菌药物的不合理使用分析[J].中国处方药,2015,13(9):33.