290例白内障患者围手术期预防用药情况调查分析

目的了解我院抗菌药物专项整治活动开展以来，白内障患者超声乳化手术预防使用抗菌药物的改善情况，为临床合理用药提供参考。方法调查我院2012年度出院的290例白内障手术患者病历，依据《抗菌药物临床应用指导原则》和《关于抗菌药物临床应用管理有关问题的通知》要求，对数据进行统计分析。结果所有患者在围手术期预防应用抗菌药物比例为100．O％，其中全身性用药98．3％，局部用药100％；预防用药开始时间在术前0．5～2h或在麻醉诱导开始时，仅术前0．5～2h给药1次129例（44．5％）；术前0．5～2h给药1次，术后〈24h给药1次63例（21．7％），术前0．5—2h给药1次，术后应用2d．82例（28．3％）：术后应用〉2d，11例（3．8％）；未全身预防用药者5例（1．7％），而所有患者局部预防用药均在手术前1日开始使用；患者平均住院床日为4．3d。结论我院白内障患者超声乳化手术预防应用抗菌药物较为合理，但依然存在个别患者全身预防用药选药欠妥、联合用药、过度用药、局部术前用药时间过短等问题，应进一步规范抗菌药物的应用管理。

290 Cases of Cataract Patients During Operation Period of Investigation and Prevention Analysis

Objective To carry out special rectification activities about drugs in this hospital since antibacterial, antimicrobial drug prevention and improvement of cataract ultrasonic emulsification operation, to provide references for clinical rational drug use. Methods Investigation of this hospital in 2012 of 290 discharged patients with cataract operation patient records, on the basis of ＂principles to guide the clinical application of antibacterial drugs＂ and ＂on issues related to the management in clinical application of antibacterial drugs notice＂ requirements, statistical analysis of data. Results All patients in peri operation period of preventive use of antibiotics ac- counted for 100% ,of which 93.3% systemic medication, 100% local application;preventive medication start time were preoperatively in 0.5 ~ 2 h or in the induction of general anesthesia, only preoperative 0.5 - 2 h administered 1 times in 129 cases （44.5%） ; preop- erative 0.5 -2 h was administered to 1 second, after 〈 24 h Administration for 1 times in 63 cases （21.7%） ;preoperative 0.5 - 2 h Administration for 1 times,the application of 2d in 82 cases （23.3%） ;11 cases of 2 d application,after the operation （3.8%） ;5 ca- ses without systemic prevention drug users （1.7%） ;5 cases without artificial crystal implant patients,and all patients with local drug prevention in the day before the operation began to use; the average length of bed for 4.3 d. Conclusion Preventive application of anti- biotics in our hospital is reasonable in patients with cataract ultrasonic emulsification operation, but there are still some patients with systemic prophylactic drug, drug combination, not excessive use,local premedication for too short a time and other issues, should be fur- ther standardized management of antibiotics application.