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实施专项整治后南通市7家医院胸外科围术期预防性使用抗菌药物的调查分析
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| 篇名： | 实施专项整治后南通市7家医院胸外科围术期预防性使用抗菌药物的调查分析 |
| TITLE： | |
| 摘要： | 目的：了解南通市7家医院胸外科围术期预防性使用抗菌药物的情况，为患者临床合理用药提供参考。方法：选取南通市7家“三级”医院2015－2016年行胸外科手术的出院患者6 652例进行回顾性分析。统计患者的性别、年龄、住院时间、术前用药情况、用药时机、切口分类、手术时间、药物名称、用法用量、给药途径、联合用药、预后情况等。根据整治活动相关规定和围术期抗菌药物使用原则对抗菌药物预防性使用的合理性进行评价。结果：6 652例患者中，Ⅰ类切口共有2 761例，Ⅱ类切口共有3 891例，全部使用了抗菌药物。初次预防用药时机在术前0.5～2 h的共有5 282例，占79.40％；术前2 h以上或术后给药的有1 370例，占20.60％。预防用药48 h以内的有1 070例，占16.09％；超过48 h的有5 582例，占83.91％。单用一种抗菌药物的有5 702例，两联用药的有950例。共有6 342例患者不合理使用抗菌药物，占95.34％。使用的抗菌药物共涉及八大类15个品种，使用最多的为β-内酰胺类/β-内酰胺酶抑制剂、氟喹诺酮类和氧头孢烯类。结论：专项整治后，南通市7家医院胸外科预防性使用抗菌药物仍存在诸多不合理现象，部分指标超出国家规定，仍需进一步管理和改进。 |
| ABSTRACT： | OBJECTIVE： To investigate the perioperative prophylactic use of antibiotics in thoracic surgery department of 7 hospitals in Nantong city， and to provide reference for rational drug use in clinic. METHODS： In retrospective study， 6 652 discharged patients with thoracic surgery were selected from 7 “third-level hospitals” of Nantong city during 2015-2016. The gender， age， length of stay， preoperative medication， medication timing， classification of incision， operation time， drug name， usage and dosage， route of administration， drug combination and prognosis were analyzed statistically. According to the relevant regulations of special rectification and the principle of perioperative antibiotics use， the rationality of antibiotics use was evaluated. RESULTS： Among 6 652 patients， there were 2 761 cases of typeⅠincision and 3 891 cases of type Ⅱ incision. All of them used antibiotics. Primary prophylactic time was 0.5-2 h before operation in 5 282 cases， accounting for 79.40％； 1 370 cases were given medicine more than 2 h before surgery or after surgery， accounting for 20.60％. Totally 1 070 cases received prophylactic medication within 48 h， accounting for 16.09％； 5 582 cases received prophylactic medication more than 48 h， accounting for 83.91％. A total of 5 702 cases were given only one antibiotic， and 950 cases received two-drug combination. A total of 6 342 patients used antibiotics irrationally， accounting for 95.34％. Eight categories 15 kinds of antibiotics were involved. β-lactam/β-lactamase inhibitors， fluoroquinolones and cephalosporins were mostly used. CONCLUSIONS： After the implementation of special rectification， there are still many irrational phenomena in the prophylactic use of antibiotics in thoracic surgery department of 7 hospitals in Nantong city. Some indexes exceed the national standard and still need to be further managed and improved. |
| 期刊： | 2017年第28卷第35期 |
| 作者： | 贝宇飞，殷晓芹，朱永红，高捷，范义凤，徐新 |
| AUTHORS： | BEI Yufei，YIN Xiaoqin，ZHU Yonghong，GAO Jie，FAN Yifeng，XU Xin |
| 关键字： | 胸外科；围术期；抗菌药物；预防性使用；合理应用 |
| KEYWORDS： | Thoracic surgery department； Perioperative period； Antibiotics； Prophylactic use； Rational use |
| 阅读数： | 287 次 |
| 本月下载数： | 3 次 |
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