[关键词]
[摘要]
目的 调查成都市公共卫生临床医疗中心HIV感染患者在I类切口手术中抗菌药物的使用情况,分析其用药合理性。方法 选取成都市公共卫生临床医疗中心2012年1月—2015年8月接受I类切口手术的218份感染HIV患者的病历进行回顾性调查分析。结果 218份病例中预防使用抗菌药物的有138例,其中以第1代头孢菌素为主;用药时间基本(98.55%)在术前30 min,手术时间超过3 h术中均追加一剂抗菌药物;用药疗程小于48 h的占77.58%;术后6例切口部位感染,10例并发肺部感染。CD4+值与术后感染率呈反比,同时预防性使用抗菌药物后,切口感染发生率为2.75%。结论 成都市公共卫生临床医疗中心抗菌药物使用情况基本合理,但仍存在选药不合理,给药时机不恰当,用药时间偏长的问题。需要采取相应的干预措施,规范围手术期预防抗菌药物的使用。
[Key word]
[Abstract]
Objective To investigate the usage of antibiotics in patients with HIV-infection undergoing type I incision surgery in Public Health Clinical Center of Chengdu, and to analyze the rationality of drug use.Methods Records (218 cases) of patients with HIV-infection undergoing type I incision surgery in Public Health Clinical Center of Chengdu from January 2012 to August 2015 were reviewed retrospectively. Results There were 138 cases of prophylactic application of antibiotics in 218 medical records. Most of antibiotics were first - generation cephalosporins. The application time of most antibiotics (98.55%) was 30 min before surgery. When the operation lasted more than 3 h, the patients were received additional medication. The constituent ratio of the course of treatment that was less than 48 h was 77.58%. There were 6 cases of surgical site infection, and 10 cases of concurrent pulmonary infection. The number of CD4+ was negatively correlated with postoperative infection, and the incidence of incision infection was 2.75%. Conclusion The use of antibiotics in Public Health Clinical Center of Chengdu is basically rational, but the problems such as the irrationality of drug choosing, inappropriate time, or long time of drug use still existed. The relative intervention measures are needed to guard the perioperative prophylactic application of antibiotics.
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[基金项目]
四川省医学会重症医学(国瑞)专项科研课题(2015ZZ006(GR)