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目的:评价我院剖宫产手术围手术期预防性使用抗菌药的合理性。方法:回顾性调查我院计划性剖宫产手术出院病历211例,以《抗菌药物临床应用指导原则》为标准,评价适应证、药物选择、用药时间、溶媒选择、溶媒用量、用法用量、联合用药、用药疗程、更换药品等各项指标的合理性。结果:围手术期预防性抗菌药使用率100%,均为静脉给药;抗菌药按频次高低排序前5位分别是阿莫西林/舒巴坦、甲硝唑、头孢呋辛、头孢哌酮、克林霉素;平均用药天数6.8 d;无1例在手术开始前2 h内或结扎脐带后给药,术前1 d开始用药占12.8%,术后开始用药占87.2%;在抗菌药的用法、用量、溶剂、联合用药等方面,也存在不合理之处。结论:我院剖宫产手术围手术期预防用药存在不合理现象,需积极改进。
Objective: To evaluate the rationality of prophylactic use of antibacterials during cesarean section in our hospital during perioperative period. Methods: A retrospective survey of 211 cases of planned cesarean section in our hospital was performed. According to the Guiding Principles of Antibacterial Drugs, the indications, choice of drugs, time of administration, choice of vehicle, amount of solvent, dosage and combination Medication, medication course, the replacement of drugs and other indicators of the rationality. Results: The perioperative prophylactic antimicrobial use rate was 100%, all of which were administered intravenously. The top five antimicrobial agents were amoxicillin / sulbactam, metronidazole, cefuroxime, cefoperazone , Clindamycin; the average number of days of medication was 6.8 days; none of them was administered within 2 h before the operation or after ligation of the umbilical cord. The dosage was 12.8% on the first day before operation and 87.2% after the start of the operation. Usage, dosage, solvents, combination therapy, there are also unreasonable. Conclusion: Perioperative prophylaxis of caesarean section in our hospital is unreasonable, and it needs to be improved actively.