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目的:了解基层卫生院妇产科围手术期抗菌药物的应用情况,为合理应用抗菌药物提供参考。方法:通过2011年医疗质量监督考核对24个乡镇卫生院产科手术病历进行回顾分析,每个医院抽取20份,共480份,根据抗菌药物临床应用指导原则等相关资料评价妇产科围手术期抗菌药物用药指征、时间、剂量、禁忌证、预后、不良反应及联合应用比率。结果:抗菌药物应用率为100%,共4类9个品种。以术后预防用药为主,注射用抗菌药物前5位为硝唑注射液(76.4%)、注射用头孢他啶(42.1%)、注射用头孢匹胺(34.6%)、注射用阿奇霉素(10.0%)、注射用头孢曲松钠(5.8%),联合应用头孢菌素类和硝咪唑类占96.4%。结论:基层产科围手术期预防性应用抗菌药物不合理,用药时机及疗程不当、联合用药不合理、应用孕妇及哺乳期禁用的抗菌药物,需加强基层医疗机构抗菌药物临床应用管理。
Objective: To understand the application of perioperative antibiotics in obstetrics and gynecology department of primary health care center and to provide a reference for rational use of antibiotics. Methods: The medical records of 24 township hospitals were reviewed retrospectively by the medical quality supervision and examination in 2011. Each hospital collected 20 copies of 480 copies. According to the clinical application guidelines of antimicrobial agents and other related information, we evaluated the perioperative period of obstetrics and gynecology perioperative period Antibacterial medication indications, time, dose, contraindications, prognosis, adverse reactions and combined application rate. Results: The application rate of antibacterial drugs was 100%, a total of 4 categories and 9 varieties. The top 5 antibiotics for injection were nitazoxanide (76.4%), ceftazidime (42.1%), cefpiramine for injection (34.6%), azithromycin for injection , Ceftriaxone sodium for injection (5.8%), combined use of cephalosporins and nitrofurazole accounted for 96.4%. Conclusions: The prevention and the application of antimicrobial agents in perioperative period in primary obstetrics are unreasonable. The timing and course of medication are not appropriate. The combined use of drugs is unreasonable. The application of antimicrobial drugs for pregnant women and lactation is prohibited. The clinical application of antimicrobial agents in primary medical institutions should be strengthened.