我院急性胰腺炎患者抗菌药物使用分析
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篇名: 我院急性胰腺炎患者抗菌药物使用分析
TITLE:
摘要: 目的: 评价我院急性胰腺炎(AP)患者抗菌药物治疗方案的实施情况及合理性。方法: 收集我院2013年8月-2015年12月收治的132例AP患者信息,统计其使用抗菌药物的品种、联合用药、用法用量等指标,分析其用药合理性。结果: 132例AP患者中,男性103例,女性29例,平均年龄(43.75±1.26)岁,轻症急性胰腺炎(MAP)117例(88.64%),重症急性胰腺炎(SAP)15例(11.36%);AP的前3位诱因分别为梗阻因素(32.31%)、高脂血症(27.21%)和酒精因素(18.03%),症状主要为腹痛、腹胀和呕吐;132例AP患者中,治愈101例,好转31例;使用抗菌药物的MAP、SAP分别为107例和13例,其抗菌药物总体使用率为90.91%(其中90.15%属于治疗性用药);共使用5种抗菌药物,其中联用抗菌药物的比例为77.28%,二联所占比例最多(69.70%),二联用药主要为“头孢哌酮钠舒巴坦钠+替硝唑”(45.65%)与“左氧氟沙星+替硝唑”(27.17%);经过治疗,患者血清淀粉酶水平、中性粒细胞百分比及白细胞计数均恢复至正常范围。结论: 我院AP患者抗菌药物使用基本合理,符合相关指南要求,但预防使用的合理性仍有待商榷。
ABSTRACT: OBJECTIVE: To evaluate the situation and rationality of the implementation of antimicrobial therapy for patients with acute pancreatitis (AP)in our hospital. METHODS: 132 AP patients admitted into our hospital during Aug. 2013-Dec. 2015 were selected and analyzed statistically in respects of the types of antimicrobial agents, drug combination, usage and dosage, etc. The rationality of antimicrobial agents use was also analyzed. RESULTS: Among 132 AP patients, there were 103 men and 29 women; mean age of them was (43.75±1.26) years; mild acute pancreatitis (MAP, 117 cases) accounted for 88.64%, and severe acute pancreatitis (SAP, 15 cases) accounted for 11.36%; the top 3 causes of AP were obstruction factors (32.31%), hyperlipidermia (27.21%) and alcohol (18.03%), respectively. Main symptoms were abdominal pain, abdominal distension and vomiting; among 132 AP patients, 101 cases were cured and 31 cases were recovered. The antimicrobial agents were used in 107 MAP cases and 13 SAP cases, and the total utilization ratio was 90.91% (of which, 90.15% belonged to therapeutic drug use). A total of 5 species were used, the combination proportion of which was 77.28%, among which two-drug combination was the most (69.70%), mainly including “sulbactam sodium and cefoperazone+tinidazole” (45.65%) and “levofloxacin+tinidazole” (27.17%). After treatment, patient’s serum amylase level MEUT and WBC recovered to normal range. CONCLUSIONS: The utilization of antimicrobial agents in our hospital is basic reasonable for AP patients, meat the requirements of the releveant guidelines. The rationality of prophylactic use of agents remain to be discussed.
期刊: 2016年第27卷第32期
作者: 张蔚,黄丽,龙丽辉
AUTHORS: ZHANG Wei,HUANG Li,LONG Lihui
关键字: 急性胰腺炎;抗菌药物;合理性评价
KEYWORDS: Acute pancreatitis; Antimicrobial agents; Rationality evaluation
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