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目的对352例2014年8月至2016年1月上海市东方医院妇产科Ⅱ类切口手术患者预防性抗生素应用进行回顾性调查分析,探讨妇产科Ⅱ类切口围手术期抗生素预防使用存在的问题,以利减少抗生素的不合理应用。方法采用上海市东方医院病案室纸质病历管理系统,以“切口手术”为检索词,随机抽取上海市东方医院2014年8月至2016年1月妇产科住院病例400例,其中352例为Ⅱ类切口,对352例妇产科Ⅱ类切口手术患者的相关资料(年龄、性别、临床诊断、手术名称、手术时间、用药特征、用药时间、抗生素名称、以及联合用药、术后有无相关感染情况等)进行分析和统计。结果在352例妇产科Ⅱ类切口手术患者中,其中抗生素预防性用药352例(100%),联合使用两种抗生素10例(2.84%),预防性应用抗生素排在前3位的依次是第1代头孢菌素(头孢唑啉)、第2代头孢菌素(头孢替安)、林可酰胺类(克林霉素)。围手术期平均用药3 d。结论上海市东方医院妇产科围手术期Ⅱ类切口预防应用抗生素较规范,存在不规范的情况:无指征延长用药、需加强抗菌素应用规范的管理,提高临床用药的科学性。
Objective To retrospectively investigate the application of prophylactic antibiotics in 352 patients from Department of Obstetrics and Gynecology, Shanghai Oriental Hospital from August 2014 to January 2016, and to discuss the perioperative prophylactic use of antibiotics in obstetrics and gynecology class Ⅱ incision. Problem, to reduce the irrational use of antibiotics. METHODS: A case record paper medical records management system of Shanghai Oriental Hospital was used to search for 400 cases of obstetrics and gynecology in Shanghai Oriental Hospital from August 2014 to January 2016 with the search term of “incision surgery” Cases of type II incision, 352 cases of obstetrics and gynecology class II incision surgery in patients with relevant information (age, gender, clinical diagnosis, name of the operation, operation time, medication characteristics, medication time, antibiotic name, and combination therapy, No relevant infection, etc.) for analysis and statistics. Results Of the 352 obstetrics and gynecology patients undergoing type II incision surgery, 352 (100%) were prophylactic prophylaxis with antibiotics, 10 (2.84%) with two antibiotics combined and prophylactic antibiotics in the top three were 1st generation cephalosporins (cefazolin), 2nd generation cephalosporins (cefotiam), lincosamides (clindamycin). Perioperative average medication 3 d. Conclusion Obstetrics and gynecology department of Shanghai Oriental Hospital perioperative class II incision prevention and use of antibiotics than the standard, there are non-standard situation: no indications to extend the medication, the need to strengthen the management of antibiotics to enhance the scientific use of clinical medicine.