目的 對2021—2022年天津市口腔醫(yī)院病區(qū)預(yù)防性應(yīng)用抗菌藥合理性進(jìn)行評價，分析預(yù)防用藥的影響因素，構(gòu)建風(fēng)險預(yù)測模型，篩選預(yù)防用藥高危人群，明確用藥指征，為口腔醫(yī)院臨床合理用藥提供參考。方法 收集2021—2022年天津市口腔醫(yī)院5 863例住院患者的病歷資料作為研究對象，采用SPSS 26.0軟件以及R4.0.3軟件進(jìn)行數(shù)據(jù)分析，使用率和百分比評價預(yù)防性應(yīng)用抗菌藥的合理性；通過χ²檢驗、二元Logistic回歸分析預(yù)防性應(yīng)用抗菌藥的影響因素，構(gòu)建預(yù)防用藥風(fēng)險預(yù)測模型。結(jié)果 2021—2022年天津市口腔醫(yī)院病區(qū)預(yù)防性抗菌藥使用率為42.01%，其中單聯(lián)用藥占98.09%、非限制級用藥占90.41%、頭孢菌素類占66.78%、不合理用藥占46.16%。不合理用藥的主要原因是術(shù)后用藥時間過長、術(shù)前給藥或術(shù)中追加用藥時機不當(dāng)、用藥品種選擇不當(dāng)?shù)?。多因素分析：年齡、住院天數(shù)、手術(shù)切口類別、手術(shù)時長是口腔住院患者預(yù)防用藥的影響因素（P<0.05），基于上述風(fēng)險因素構(gòu)建預(yù)防性應(yīng)用抗菌藥的風(fēng)險預(yù)測模型。結(jié)論 2021—2022年天津市口腔醫(yī)院病區(qū)患者預(yù)防性抗菌藥使用存在諸多不合理現(xiàn)象，分析預(yù)防用藥的影響因素很多且相互關(guān)聯(lián)；口腔類機構(gòu)可根據(jù)由年齡、住院天數(shù)、切口類別、手術(shù)時長對住院患者建立預(yù)防性應(yīng)用抗菌藥的風(fēng)險模型，篩選預(yù)防用藥高危人群，明確預(yù)防用藥指征，提高合理用藥水平。

Objective To evaluate the rationality of prophylactic use of antibiotics in oral inpatients, analyze the influencing factors, and build a risk prediction model, screen high-risk groups of preventive use of drugs, clarify the indications of drug use, and provide reference for clinical rational use of drugs in stomatological hospitals. Methods The medical records of 5 863 inpatients in Tianjin Stomatological Hospital from 2021 to 2022 were collected, SPSS 26.0 and R4.0.3 software are used for data analysis. The use rate and percentage were used to evaluate the rationality of preventive use of antibiotics, adopting χ² test and Logistic regression model to analysis the influencing factors of preventive use of antibiotics, and construct of risk prediction model. Results From 2021 to 2022, the use rate of prophylactic antibiotics in the wards of Tianjin Stomatological Hospital was 42.01%, of which single drug use accounted for 98.09%, non-restricted drug use accounted for 90.41%, cephalosporins accounted for 66.78%, and irrational drug use accounted for 46.16%. The main reasons for irrational use of drugs are long time of postoperative medication, improper timing of preoperative administration or additional medication during operation, and improper selection of drug varieties. Multivariate analysis:age, length of stay, type of surgical incision, and length of operation are the influencing factors of prophylactic use of antibiotics in oral inpatients (P < 0.05). Based on the above risk factors, a risk prediction model of prophylactic use of antibiotics in oral inpatients was constructed. Conclusions There are many irrational phenomena in the use of prophylactic antibiotics for patients in the wards of Tianjin Stomatological Hospital from 2021 to 2022. The analysis of the factors affecting prophylactic use are many and interrelated. Oral institutions can establish a risk model of prophylactic use of antibiotics for inpatients based on age, length of stay, type of incision, and length of operation to screen high-risk groups of preventive use of drugs, clarify the indications of prophylactic use and improve the level of rational use of drugs.

R988.2

天津市口腔功能重建重點實驗室面上/青年/研究生導(dǎo)師項目（2021KLMS10）