316 例肿瘤手术患者预防应用抗菌药物的情况分析
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Analysis of the Use of Prophylactic Antibacterial Agents of 377 Cases of Tumor Surgery Patients
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    摘要:

    目的 调查某院肿瘤患者围手术期预防应用抗菌药物的合理性,为抗菌药物的合理应用和管理提供依据。方法 回顾性调查分析2012 年7 月~ 2013 年6 月某院316例肿瘤手术患者的病历资料,按抗菌药物在围手术期预防应用指南等相关标准,对围手术期抗菌药物预防性应用的合理性进行评价。结果 Ⅰ类切口手术抗菌药物预防性使用率为63.0%,Ⅱ类切口手术抗菌药物预防性应用率92.4%;其中使用频度最高的是头孢哌酮舒巴坦钠;用药疗程24~48 h(感染率5.36%),3~7 d(感染率4.69%),>7 d(感染率19.57%),用药疗程一周以内术后的感染率无显著性差异(P>0.05),使用一周以后感染率显著高于一周内(P<0.05)。主要存在的问题有:预防用药指征把握不严、药物选择不当、用药时机不对、术后用药时间较长、用法用量不合理等。结论 某院围手术期抗菌药物预防应用仍存在不合理现象,需制定完善的围手术期预防用药管理措施,确保安全合理用药。

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    Objective To investigate the rationality of perioperative prophylactic use of antibacterial agents by the tumor patients in a hospital, and offer evidence for reinforcing the rational use and standard management of antibacterial agents. Methods According to the guide of prophylactic antibacterial agents in perioperative period and the relevant standards, the medical records of 337 patients with tumor surgery from July 2012 to June 2013 were retrospectively reviewed and analyzed, the application status of antibacterial agents in perioperative period were rationally evaluated. Results The utilization rate of preventive antibacterial agents is 63.0% in the patients with Ⅰtype incision and the utilization rate of preventive antibacterial agents is 92.4% in the patients with Ⅱ type incision. Among those antibacterial agents, the frequency of use of cefoperazone sulbactam is highest. The percent of infection after operation in 24~48 h, 3~7 d, >7 d group were 5.36%, 4.69%, 19.57%, respectively. No difference of infection percents was found between 24~48 h and 3~7 d group (P>0.05). The percent of infection in >7 d group was higher than that in 24~48 h or 3~7 d group (P<0.05). The main problems such as not confirming medication indicator、improper drug selection、inappropriate time of initial administration、prolonged application, irrational use in dosage and administration exist in the perioperative prophylactic use of antibacterial agents. Conclusion Application of preventive antibacterial agents to patients of tumor surgery perioperation period is not reasonable. It is suggested to intensify supervison and regulate the rational use of antibacterial agents.

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向春红,肖轶雯,李群,等.316 例肿瘤手术患者预防应用抗菌药物的情况分析[J].肿瘤药学,2013,(6): ( in Chinese)

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