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目的分析本院乳腺良性肿瘤围手术期预防性抗菌药物应用基本情况及存在问题。方法收集乳腺肿瘤3个区2008年1月～12月乳腺良性肿瘤患者病历,其中符合条件的共计1007份,对围手术期预防应用抗菌药物的合理性进行评价分析。结果①围手术期预防性抗菌药物的使用率为95.7%;②用药种类:按频次高低排序前3位是青霉素类(48%)、青霉素类+酶抑制剂(18.2%)、喹诺酮类(15.8%);③手术后平均用药48h;④用药时机:手术开始前2h内用药者99%,手术结束后用药者5.2%;⑤用药剂型选择:静脉给药56.6%,口服给药33.4%,静脉与口服混合给药5.7%;⑥抗菌药物的用法、用量及药物更换等方面,存在诸多不合理现象。结论本院乳腺良性肿瘤围手术期预防性抗菌药物应用率过高,疗程过长,在药物选择、剂型选择、用药时机方面不合理、不规范的情况比较普遍,改进的空间较大。
Objective To analyze the basic situation and existing problems of perioperative prophylactic antibacterials in breast benign tumors in our hospital. Methods The medical records of breast benign tumor patients from January 2008 to December 2008 in 3 regions of breast cancer were collected. A total of 1007 eligible cases were collected, and the rationality of perioperative prophylaxis with antimicrobial agents was evaluated. Results ① The rate of perioperative prophylactic antibacterials was 95.7%. ② Types of drugs: The top three ranked by frequency were penicillins (48%), penicillins + inhibitors (18.2%), quinolones (15.8 %); ③ average postoperative 48h medication; ④ timing of the medication: 99% within 2h before surgery, and 5.2% after the end of surgery; ⑤ choice of drug type: intravenous 56.6%, oral administration of 33.4% Mixed with oral administration of 5.7%; ⑥ antibacterial drugs usage, dosage and drug replacement, there are many irrational. Conclusions The perioperative prophylactic antimicrobial application rate of breast benign tumor in our hospital is too high and the course of treatment is too long. It is not reasonable in terms of drug selection, dosage form selection and medication timing. The non-standardization is more common and the room for improvement is larger.