围手术期抗菌药物用药监控的价值及作用评价

目的:探讨用药监控在临床围手术期抗菌药物应用中的意义,并评价其作用。方法:随机选取246份手术病历,统计其I、II类切口手术病种、例数、术前预防性使用抗菌药物情况、抗菌药物使用前细菌学监测情况、术后切口或院内感染情况及选药合理性等,并进行合理分析。结果:实施用药监控后,临床选用一、二代头抱菌素的病例较前显著增加,同时大大减少了三、四代头抱菌素和加酶抑制剂品种的使用;用药前细菌学检查率低,多数采用经验用药;在术前使用了抗菌药物的病例中,用药时间在术前0.5～2h内的共有236例,占95.93%;两组术后切口和院内感染的发生率差异无统计学意义(P0.05)。结论:实施用药监控可以帮助提高围手术期抗菌药物使用的合理性。

Drug Monitoring in the Perioperative Application of Antibiotics and the Role of the Rational Evaluation

Objective：To evaluate the clinical drug monitoring in perioperative period in the significance of antimicrobial agents and to evaluate its role.Methods：246 randomly selected medical records were surgery, statistics of its I, II class incision disease and patients, and preoperative prophylactic use of antimicrobial drugs, antimicrobial drug use prior to bacteriological monitoring of the situation, incision, or nosocomial infection and the election drugs such as rationality, and reasonable analysis.Results：After the implementation of drug monitoring, clinical use of a second-generation cephalosporins in patients was significantly increased compared with the same time greatly reducing the third and fourth generation cephalosporins and enzyme inhibitors used species; bacteriological examination before treatment low, the majority of drug use experience; in the preoperative use of antibiotics in the cases, the medication time 0.5～2 h before surgery within a total of 236 cases, accounting for 95.93%; two incision and the difference in the incidence of nosocomial infection No statistically significant （P0.05）.Conclusion：The drug monitoring can improve the use of perioperative antibiotics is reasonable.