目的 了解2018年西安醫(yī)學院附屬寶雞醫(yī)院Ⅰ類切口圍手術期抗菌藥物預防性使用現狀，分析評價用藥合理性，為抗菌藥物合理性應用管理提供客觀依據。方法 抽取西安醫(yī)學院附屬寶雞醫(yī)院2018年1~12月Ⅰ類切口手術病例共872份，從適應癥、品種選擇、用法用量、用藥時機、術中追加以及用藥療程等內容進行評價分析。結果 Ⅰ類切口手術病例預防應用抗菌藥物288例，使用率為33.03%；使用品種有14個，使用頻率最高的是第2代頭孢菌素頭孢呋辛，構成比為50.68%；術前0.5~1 h給藥的患者263例，合理率為91.32%；用藥療程≤ 24 h的患者55例，合理率為19.1%；聯合用抗菌藥物6例，均無聯合用藥指證。結論 西安醫(yī)學院附屬寶雞醫(yī)院Ⅰ類切口圍手術期預防用抗菌藥物存在用藥指證把握不嚴、藥物選擇不合理、用藥療程過長等問題，需加強規(guī)范管理，促進抗菌藥物的合理應用。

Objective To investigate the application of prophylactic antibacterial drugs in perioperative period of type I incision in Affiliated Baoji Hospital of Xi' an Medical University in 2018, and to analyze and evaluate the rationality of drug use, to provide basis for the rational use of antibiotics in the clinic. Methods Medical records (872 cases) having surgery with type I incision from January to December 2018 in Affiliated Baoji Hospital of Xi' an Medical University were selected, and indication, variety choice, administration time, course of treatment, usage and dosage, and combination of antibiotics were analyzed. Results There were 288 cases of perioperative use of antibiotics in patients with type I incision, with the application rate of 33.03%. A total of 14 types of antibiotics were used, and most of them were second generation cephalosporin cefuroxime sodium, accounting for 50.68%. The antibiotics were used 0.5-1 h before surgery in 263 cases with the application rate of 91.32%. The course of treatment of antibiotics was not more than 24 h in 55 cases with the application rate of 91.32%. There were 6 cases of combination of antibiotics, and there was no indication of combination therapy. Conclusion There is still existed unreasonable prophylactic application of antibiotics for type I incision, such as improper indication of drug use, inappropriate selection of drug varieties, and serious situation of combined drug use. It is necessary to further strengthen the management and continuously promote the rational use of antibiotics in the clinic.

R978.1