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目的分析妇科手术围术期抗菌药使用情况,为临床合理用药提供指导。方法回顾性分析上虞中医医院妇科于2013年1月-2015年12月收治行手术患者病历773份,统计和评价围术期抗菌药使用的合理性。结果 773份病历中,共使用抗菌药958次,涉及4大类7个品种,头孢菌素类使用频次最高71.92%,其中3代头孢比例最高63.88%。抗菌药用药时间为1~22 d。围手术期抗菌药使用时间不合理性主要为术前给药时机(43.47%),其次为术后持续用药时间(29.24%)和术中追加时机(27.17%)。药物联用率24.32%(188例次),其中不合理联用72例次,主要为无指征联用(40.28%),其次为联用毒性(29.17%)和无协同作用(18.05%)。结论上虞中医医院妇科在围手术期抗菌药物的应用不合理较普遍,主要表现为抗菌药种类选择、使用时机和药物联用不合理。
Objective To analyze the use of antibacterials in perioperative period of gynecological surgery and provide guidance for clinical rational use of drugs. Methods A retrospective analysis of gynecology in Shangyu Chinese Medicine Hospital from January 2013 to December 2015 admitted 773 patients with surgical records, statistical and evaluation of the rational use of perioperative antibacterials. Results A total of 958 antibacterials were used in 773 medical records, involving 7 varieties in 4 major categories, the highest frequency of cephalosporins being 71.92%, and the highest percentage of third-generation cephalosporins being 63.88%. Antibacterial medication time is 1 ~ 22 d. The irrational use of perioperative antibacterials was mainly preoperative timing (43.47%), followed by continuous treatment time (29.24%) and intraoperative additional timing (27.17%). The drug combination rate was 24.32% (188 cases), of which 72 cases were unreasonably combined with 40.28% of the patients without combined indications, followed by combined toxicity (29.17%) and no synergistic effect (18.05%), . Conclusions The application of gynecology in Shangyu Chinese Medicine Hospital during perioperative period is unreasonable and widespread. The main manifestations are the choice of antimicrobial agents, the timing of use and the irrational combination of drugs.