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目的了解郑州大学附属肿瘤医院妇科肿瘤患者围术期抗菌药物的应用情况,探讨妇科肿瘤患者围术期预防用抗菌药物合理应用的可行性。方法抽取妇瘤科2010、2013年10—11月Ⅰ、Ⅱ类切口手术患者病历286份,将2010年10—11月137份手术病历设为干预前组,2013年10—11月149份手术病历设为干预后组,对2组患者术前预防用药时机、抗菌药物预防性应用疗程、预防用抗菌药物品种选择、预防用抗菌药物使用率及术后感染率进行统计、分析。结果妇科肿瘤患者围术期预防应用抗菌药物,在给药时机、用药疗程、药物选择、联合用药及抗菌药物使用率等方面较干预前均有明显改善,差异均有统计学意义(P<0.05)。结论妇科肿瘤Ⅰ类切口手术围术期不需要预防性应用抗菌药物;妇科肿瘤Ⅱ类切口手术围术期预防性使用头孢呋辛48h的用药方案能够有效预防术后感染。
Objective To understand the application of perioperative antibiotics in patients with gynecologic oncology in Affiliated Tumor Hospital of Zhengzhou University and to explore the feasibility of rational use of perioperative prophylactic antibiotics in gynecologic cancer patients. Methods A total of 286 cases of patients undergoing type Ⅰ and Ⅱ incision surgery from March 2010 to October 2013 were enrolled in this study. 137 cases of surgical records from October to November in 2010 were selected as the intervention group, 149 cases in October-November 2013 The medical record was set as the intervention group. The preoperative prophylaxis timing, prophylactic application course of antimicrobial agents, selection of prophylactic antibacterials, prophylactic antimicrobial use and postoperative infection rate were statistically analyzed. Results The perioperative prophylaxis and application of antimicrobial agents in patients with gynecologic cancer showed significant improvement in timing of administration, duration of medication, choice of drugs, combination therapy and antibacterial drug use rate, with significant differences between before and after intervention (P <0.05 ). Conclusions There is no need for prophylactic use of antimicrobial agents in gynecologic oncology class Ⅰ incision. Preventive use of cefuroxime for 48 h in gynecologic oncology class Ⅱ incision can effectively prevent postoperative infection.