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目的:回顾性调查分析我院2009年颌面外科手术患者围手术期预防性应用抗菌药情况,以提高抗菌药在颌面外科手术预防应用中的合理性。方法:利用我院HIS系统随机抽取2009年1～12月颌面外科择期手术患者的病历,依据卫生部相关文件及规定对手术抗菌药预防性应用中药物的选择、用药时机及联合用药等情况进行调查分析。结果:共随机抽取158例手术患者病历,其中Ⅰ类手术切口33例,Ⅱ类手术切口125例。所有手术患者术后均使用了抗菌药。选择频次排在前三位的分别是头孢替安、青霉素钠、头孢硫脒。有2例术前未用药术后口服给药,手术时间超过3 h的27例手术中有24例术中追加一剂抗菌药。术后用药时间方面:Ⅰ类手术切口超过48 h者28例,占Ⅰ类手术切口类型的84.85%;Ⅱ类手术切口超过72 h者90例,占Ⅱ类手术切口类型的72%。结论:所抽查的158份病历,在药物的术前预防用药时间及联合用药方面较为合理,在手术预防用抗菌药的选择、术中追加抗菌药、术后用药时间、预防用药给药途径等方面存在某些不合理现象,有待进一步改进。
OBJECTIVE: To retrospectively investigate the perioperative prophylactic use of antibacterials in patients undergoing maxillofacial surgery in our hospital in 2009 to improve the rationality of antibacterials in the prevention and treatment of maxillofacial surgery. Methods: The records of patients undergoing elective maxillofacial surgery from January to December 2009 were randomly selected from the HIS system of our hospital. According to the relevant documents and regulations of the Ministry of Public Health, the selection of drugs, the timing of medication and the combination of drugs in prophylactic use of surgical antibiotics Conduct investigation and analysis. Results: A total of 158 surgical patients were randomly selected, including 33 cases of type Ⅰ surgical incision and 125 cases of type Ⅱ surgical incision. All patients underwent surgery with antibacterials. Select the top three ranked frequency are cefotiam, penicillin sodium, cefathiamidine. There were 2 cases of oral administration of medicine before surgery and 24 cases of surgery requiring more than 3 hours of operation for an additional antibacterial drug. Postoperative medication time: Ⅰ class surgical incision more than 48 h in 28 cases, accounting for 84.85% of the type Ⅰ surgical incision; class Ⅱ surgical incision more than 72 h in 90 cases, accounting for type Ⅱ surgical incision 72%. Conclusion: The 158 medical records examined were reasonable in preoperative prophylaxis medication and combination therapy. In the selection of antimicrobial agents for surgery prophylaxis, antibacterial drugs were added during the operation, the time of postoperative medication, the route of administration of prophylactic drugs, etc. There are some irrational aspects, pending further improvement.