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目的:了解湖南省儿童医院外科手术围术期抗菌药物的使用情况,并作出客观评价。方法:随机抽取该院2011年7月至2011年12月外科手术住院病历600份,调查不同切口类型手术围术期预防使用抗菌药物的情况。对抗菌药物的选择、适应证、术前用药时间、联合用药及疗程等进行合理性评价。结果:围术期抗菌药物使用率为70.5%(423/600),Ⅰ类切口抗菌药物使用率达到55.0%(202/367),远高于卫生部不超过30%的规定。预防性抗菌药物选用起点过高,用药时间过长,不合理率为20.2%(121/600);联合用药、药物更换均存在不合理现象。结论:该院外科围术期抗菌药物应用仍存在选药档次偏高、药物品种选择欠适宜、术后预防用药时间偏长等问题,需继续加强对围术期抗菌药物使用的监督和指导。
Objective: To understand the perioperative use of antibacterials in surgical operation in Hunan Children’s Hospital and to make an objective evaluation. Methods: From July 2011 to December 2011 in our hospital, 600 cases of surgical inpatients were randomly selected to investigate the prevention of the use of antimicrobial agents in different types of incisions during perioperative period. The choice of antimicrobial agents, indications, preoperative medication time, combined with medication and treatment for reasonable evaluation. Results: The perioperative antibacterials utilization rate was 70.5% (423/600), and the usage rate of Class I incision antibacterials was 55.0% (202/367), which was much higher than the Ministry of Health’s maximum of 30%. Preventive antibacterial drug selection starting point is too high, medication time is too long, unreasonable rate of 20.2% (121/600); combination of drugs, drug replacement are unreasonable. CONCLUSION: There are still some problems in the perioperative application of antibiotics, such as high grade of drug selection, inadequate selection of drug varieties and long time of postoperative preventive medication. Supervision and guidance on perioperative use of antimicrobial agents should be further strengthened.