目的 對2018年荊門地區(qū)10家醫(yī)院剖宮產(chǎn)圍術(shù)期預(yù)防用抗菌藥物的合理性進(jìn)行分析，加強(qiáng)荊門地區(qū)醫(yī)院剖宮產(chǎn)圍術(shù)期預(yù)防性抗菌藥物的合理使用與管理。方法 回顧性抽取荊門地區(qū)2018年10家醫(yī)院（三級綜合醫(yī)院4家，二級綜合醫(yī)院3家，?？漆t(yī)院3家）剖宮產(chǎn)手術(shù)患者病歷968份，對圍術(shù)期抗菌藥物的品種選擇、首劑給藥時機(jī)、給藥療程和聯(lián)合用藥情況進(jìn)行統(tǒng)計分析。結(jié)果 參與調(diào)查的10家醫(yī)院抗菌藥物使用率均達(dá)100%，品種選擇合理率三級醫(yī)院79.5%，二級醫(yī)院75.4%，?？漆t(yī)院87.8%；首劑給藥時間三級醫(yī)院和?？漆t(yī)院均在臍帶結(jié)扎后，二級醫(yī)院69.4%在臍帶結(jié)扎后，30.6%在術(shù)后給藥；平均給藥療程三級醫(yī)院為2.7 d，二級醫(yī)院為3.5 d，?？漆t(yī)院為2.3 d?？咕幬锏氖褂么蟛糠譃閱斡?，但也存在少數(shù)患者有二聯(lián)用藥，無三聯(lián)使用抗菌藥物的情況。結(jié)論 荊門地區(qū)醫(yī)院剖宮產(chǎn)圍術(shù)期抗菌藥物品種的選擇趨于合理，用法用量逐步規(guī)范合理，但首劑給藥時機(jī)和用藥療程仍存在不合理之處。

Objective To analyze the reasonable use of prophylactic antibacterial drugs in perioperative period of cesarean section in 10 hospitals of jingmen area in 2018, and to strengthen the rational use and management of prophylactic antibiotics in perioperative period of cesarean section in hospital of jingmen area. Methods 968 Medical records of patients underwent external abdominal hernia surgery were collected from 10 hospitals of jingmen area (4 third-level hospitals, 3 second-level hospitals, and 3 specialized hospitals retrospectively). The utilization of antibiotics was analyzed statistically in respect of antimicrobial species, timing of initial dose, and average treatment course. Results The utilization ratio of antibiotics was 100% in the 10 hospitals. The reasonability of type selection of antibiotics was 79.5% in third-level hospitals, 75.4% in second-level hospitals, and 87.8% in specialized hospitals. The timing of initial dose was administered after the umbilical cord ligation in third-level hospitals and specialized hospitals, 69.4% was administered after the umbilical cord ligation in second-level hospitals, and 30.6% was administered after the postoperative. The average treatment course was 2.7, 3.5, and 2.3 d. The use of antibiotics was mostly single use, but there were also a few patients who had two combinations of antibiotics and no three combinations of antibiotics. Conclusion The type selection of antibiotics in perioperative period of cesarean section from the hospitals of jingmen area tends to be scientific, and the usage and dosage are gradually standardized and reasonable, but the timing of initial dose and drug treatment are still unreasonable.

R969.3;R978.1

荊門市科學(xué)技術(shù)研究與開發(fā)計劃項目（2019YDKY060）