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目的:对妇产科围手术期抗菌药物的应用现状进行分析,以促进临床合理用药。方法:采用调查分析的方法,对我院近四年间妇产科围手术期患者使用抗菌药物情况进行了回顾性分析。结果:抗菌药物的使用种类为硝咪唑类、青霉素类、头抱菌素类、林可霉素类。使用率在前3位的抗菌药物分别为头孢呋辛51例(占42.5%)、甲硝唑38例(占31.7%)、克林霉素30例(占25%);采取静脉滴注的给药方式,1次/d,一般是手术中给药一次,术后连续5~7d;产科52例患者使用抗菌药物的平均天数为4.5d,妇科68例患者使用抗菌药物的平均天数为5.5d;妇科68例使用抗菌药43例,15例未使用;产科52例均使用抗菌药(P<0.05);95例使用抗菌药物的术前30min给药85例,应为合理;术前1~3天用药10例表明存在潜在感染,用药应算基本合理;术后用药76例2天内停药,基本合理;13例3天停药,算为基本合理;另外5例4~7天停药,不合理;最后1例存在术后切口感染;95例使用抗菌药后不良反应较轻微、相对较安全。结论:我院妇产科围手术期抗菌药物的使用总体来说基本合理,但也存在用药选择给药时机不当、用药时间过长的现象,需要加强相应合理用药的管理。
Objective: To analyze the current status of perioperative antibacterials in obstetrics and gynecology to promote clinical rational use of drugs. Methods: Using the method of investigation and analysis, we retrospectively analyzed the use of antibacterials in perioperative patients during the past four years in our hospital. Results: The use of antibacterial drugs for the class of nitriazole, penicillins, cephalosporins, lincomycin class. The top three antibacterials were cefuroxime in 51 cases (42.5%), metronidazole in 38 cases (31.7%) and clindamycin in 30 cases (25%). Intravenous infusion Administration mode, 1 time / d, usually given once during the operation, after continuous 5 ~ 7d; obstetric 52 patients with antibiotics average days 4.5d, gynecological 68 patients with antibiotics average number of days 5.5 d; gynecological 68 cases of antibacterials in 43 cases, 15 cases were not used; obstetric 52 cases were used antibacterial drugs (P <0.05); 95 cases of antibiotics administered preoperative 30min 85 cases should be reasonable; preoperative 1 ~ 3 days of medication in 10 cases showed the existence of a latent infection, medication should be considered basic and reasonable; postoperative 76 cases within 2 days of withdrawal, the basic reasonable; 13 cases of 3 days withdrawal, regarded as reasonable; the other 5 cases 4 to 7 days stop Medicine, unreasonable; the last case of postoperative infection incision; 95 cases of antibacterial drugs used after the minor adverse reactions, relatively safe. Conclusion: The use of perioperative antibacterials in obstetrics and gynecology department in our hospital is generally reasonable, but there are some problems such as improper timing of medication administration and overdosage of medication, and the need to strengthen the management of appropriate medication.