外科围手术期患者预防性应用抗菌药物分析

【】　目的　了解外科围手术期预防性使用抗菌药物现状，评估其用药合理性。　方法　随机抽取2009年1-12月265例外科手术患者病历，根据《抗菌药物临床应用指导原则》和《卫生部办公厅关于抗菌药物临床应用管理有关问题的通知》对抗菌药物使用进行合理性评价。　结果　265例外科手术患者均使用了抗菌药物，使用率为100%，外科围手术期预防用抗菌药物不合理率为63.89%，存在的主要问题是用药指征过宽、起点过高、手术前预防用药时间不当、术后预防用药时间过长及盲目联合用药。　结论　外科围手术期抗菌药物预防性使用不合理现象突出，应积极开展合理使用抗菌药物培训，加强抗菌药物使用管理，规范围手术期抗菌药物的使用，从而提高外科围手术期抗菌药物使用合理性。？【Abstract】　Objective　Toknowthestatusofprophylacticuseofantimicrobialagentsinperioperativepatients,andtoevaluatethemedicationrationality.　Methods　Themedicalrecordsof265patientswhounderwentthesurgeriesfromJanuarytoDecember2009wererandomlyextracted,andthemedicationrationalitywasevaluatedaccordingto"GuidingPrinciplesofClinicalUseofAntibiotics"and"NoticeofMedicalDepartmentOfficeaboutAntibioticsClinicalpracticeManagementRelatedQuestions".　Results　Allofthe265perioperativepatientsweretreatedwithantimicrobialdrugswithautilizationrateof100.00%,andtheunreasonablerateofperioperativeprophylacticuseofantimicrobialagentswas63.89%.Themainreasonsincludedover-extendedmedicationindications,highstartingpoints,inappropriatetimepointsofprophylacticmedication,longdurationofprophylacticmedicationandunreasonabledrugcombination.　Conclusion　Theperioperativeprophylacticuseofantimicrobialagentsisclinicallyunreasonable.Itisnecessarytocarryouttrainingontherationaluseofantimicrobialagentstoenhancethemanagementofantimicrobialdruguseandregulatetheuseofantimicrobialagentsinperioperation.