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目的探讨骨科Ⅰ类切口围术期预防性使用抗菌药物使用情况。方法查阅南通大学附属医院分院南通市老年康复医院药剂科2015年1—12月100例骨科Ⅰ类切口手术病历,对其抗菌药物预防性使用率、药物品种选择、给药时机、用药时间以及联合用药情况进行整理分析,并作出合理性评价。结果 100例骨科Ⅰ类切口手术患者围术期预防性使用抗菌药物的81例,占81%;其中单一用药66例,联合用药15例。预防性使用的抗菌药物主要为头孢菌素类药物,包括头孢硫脒、头孢替安、头孢曲松钠,以及林可酰胺类药物克林霉素,氟喹诺酮类药物左氧氟沙星,硝基咪唑类药物甲硝唑。45例患者在术前0.5~2.0 h预防性使用,占45.0%;>2 h使用36例,占36.0%;术中或术后追加使用75例,占75.0%。预防性使用时间<24 h的21例,24~48 h的26例,>48 h的34例。结论该院骨科Ⅰ类切口手术抗菌药物预防使用率、药物品种选择、给药时机、用药时间以及联合用药情况未完全达到国家卫生管理部门的要求,医院需加强监管,促进抗菌药物的合理使用。
Objective To investigate the preventive use of antibacterials in perioperative period of type Ⅰ incision in orthopedics. Methods A total of 100 cases of orthopedic class I incision surgical records were collected from Department of Pharmacy, Nantong Geriatric Rehabilitation Hospital, Nantong University Affiliated Hospital, Nantong University from January to December in 2015. The preventive use rate of antimicrobial agents, choice of drug type, timing of administration, duration of medication, Medication situation analysis, and make a reasonable assessment. Results Eighty-one patients (81%) received preventive perioperative antibacterials in 100 cases of orthopedic group Ⅰ incision surgery. Among them, 66 cases were single and 15 cases were combined. Preventive antibacterials are mainly cephalosporins, including cefathiamidine, cefotiam, ceftriaxone, and clindamycin, linoleamide, fluoroquinolone levofloxacin, nitroimidazole Metronidazole. Forty-five patients were prophylactically administered 0.5-2.0 h preoperatively, accounting for 45.0%; 36 patients were used for> 2 h, accounting for 36.0%; 75 patients were additionally used during or after surgery, accounting for 75.0%. Preventive use of time <24 h in 21 cases, 24 to 48 h in 26 cases,> 48 h in 34 cases. Conclusions The preventive rate of antibacterials in Class I incision surgery, the selection of drug species, the timing of drug delivery, the time of drug administration and the combination of drugs did not fully meet the requirements of national health authorities. The hospital should strengthen supervision and promote the rational use of antimicrobial agents.