目的 对2021—2022年天津市口腔医院病区预防性应用抗菌药合理性进行评价，分析预防用药的影响因素，构建风险预测模型，筛选预防用药高危人群，明确用药指征，为口腔医院临床合理用药提供参考。方法 收集2021—2022年天津市口腔医院5 863例住院患者的病历资料作为研究对象，采用SPSS 26.0软件以及R4.0.3软件进行数据分析，使用率和百分比评价预防性应用抗菌药的合理性；通过χ²检验、二元Logistic回归分析预防性应用抗菌药的影响因素，构建预防用药风险预测模型。结果 2021—2022年天津市口腔医院病区预防性抗菌药使用率为42.01%，其中单联用药占98.09%、非限制级用药占90.41%、头孢菌素类占66.78%、不合理用药占46.16%。不合理用药的主要原因是术后用药时间过长、术前给药或术中追加用药时机不当、用药品种选择不当等。多因素分析：年龄、住院天数、手术切口类别、手术时长是口腔住院患者预防用药的影响因素（P<0.05），基于上述风险因素构建预防性应用抗菌药的风险预测模型。结论 2021—2022年天津市口腔医院病区患者预防性抗菌药使用存在诸多不合理现象，分析预防用药的影响因素很多且相互关联；口腔类机构可根据由年龄、住院天数、切口类别、手术时长对住院患者建立预防性应用抗菌药的风险模型，筛选预防用药高危人群，明确预防用药指征，提高合理用药水平。

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点实验室面上/青年/研究生导师项目（2021KLMS10）