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目的:调查潮州市潮安区人民医院妇产科围手术期抗菌药物使用,提高基层医院抗菌药物使用的合理性。方法:选择2013年12月到2015年2月从潮州市潮安区人民医院的信息系统随机抽取500例产妇,采用自制量表调查其围手术期的抗菌药物使用情况,包括3个部分:基本用药、不合理用药和不良后果。结果:基本用药,(1)用药性质:预防性用药83.2%,治疗性用药16.8%;(2)用药时机:术前81.6%,术后持续1~3 d为7.6%,术后持续4~7 d为92.4%;(3)联合用药:单用为11.8%,二联为88.2%;(4)用药种类:主要为硝基咪唑类48.6%和头孢菌素类32.2%,青霉素类和大环内酯类的使用率很低。不合理用药:时间不合理7.0%,剂量不合理2.2%,联用不合理1.6%,选药不合理0.6%,合计11.4%。不良后果:消化系统反应为8.6%,神经系统反应为7.0%,血液系统反应为1.0%,肾功能反应为0.4%,肝功能反应为0.2%,术后感染1.2%,合计18.4%。结论:此基层医院妇产科围手术期抗菌药物的使用情况总的来说合理性还是较高,但还是存在一些不足,一是其专业性水平还需要进一步加强,二要避免为了追求效果而过度用药,但后者还需要相关部门给予更多的政策支持。
Objective: To investigate the use of perioperative antibiotics in the Department of Obstetrics and Gynecology, Chaoan People ’s Hospital, Chaozhou, and to improve the rationality of antimicrobial use in primary hospitals. Methods: From December 2013 to February 2015, 500 maternal women were randomly selected from the information system of People’s Hospital of Chaoan District of Chaozhou City. The use of self-made scale was used to investigate the use of antibacterial drugs in perioperative period, including three parts: basic Medication, unreasonable medication and adverse consequences. Results: The basic medication, (1) the nature of the drug: prophylactic 83.2%, therapeutic drug 16.8%; (2) the timing of treatment: preoperative 81.6%, 1-3 days after surgery was 7.6% postoperative 4 ~ 7 d was 92.4%; (3) combination therapy: 11.8% for single use and 88.2% for two together; (4) the types of drugs used: mainly 48.6% of nitroimidazoles and 32.2% of cephalosporins, penicillins and large The use of cyclic lactones is very low. Irrational use of drugs: irrational time 7.0%, irrational dosage 2.2%, unjustified 1.6%, irrational drug selection 0.6%, a total of 11.4%. Adverse effects: The digestive system response was 8.6%, the nervous system response was 7.0%, the hematological response was 1.0%, the renal function was 0.4%, the liver function was 0.2% and the postoperative infection was 1.2% (18.4% of the total). Conclusion: The use of perioperative antibiotics in primary hospitals is generally reasonable, but there are still some shortcomings. First, its professional level needs to be further strengthened. Second, it is necessary to avoid the pursuit of results Over-medication, but the latter also need more relevant departments to give policy support.