目的 分析2017-2018年天津市宝坻区人民医院万古霉素的使用情况，为促进万古霉素的临床合理使用提供参考。方法 收集天津市宝坻区人民医院2017年1月-2018年12月使用万古霉素的住院患者病历228例，对患者基本概况、科室分布、病原学检查、给药剂量、给药途径、用药疗程及血药浓度监测情况等进行回顾性统计分析。结果 228例患者中，男性（143例，62.72%）多于女性（85例，37.28%）；患者主要分布于骨科（73例，32.02%），神经外科（32例，14.04%）等；195例在使用万古霉素前进行了病原学检查，微生物检验样本送检率为85.53%；检出的病原菌主要为金黄色葡萄球菌（26例，35.62%），表皮葡萄球菌（15例，20.55%）等；193例（84.65%）为静脉滴注给药；给药剂量主要为2 g/d（156例，68.42%）；144例（63.16%）给药疗程少于7 d；39例（31.70%）行万古霉素血药浓度监测患者中，血药谷浓度维持在10~20 mg/L的为15例（38.46%）。结论 2017-2018年天津市宝坻区人民医院万古霉素总体应用基本合理，应加强万古霉素的应用管理，促进其合理使用。

Objective To analyze the clinical use of vancomycin in Tianjin Baodi People's Hospital from 2017 to 2018, and to provide reference for promoting rational use of vancomycin in the clinic. Methods 228 Inpatient medical records of vancomycin were collected from Tianjin Baodi People's Hospital from January 2017 to Decemer 2018. Retrospective method was used to analyze the overview of patients, different departments, pathogenic bacteria examination, administration of dosage, administration of route, course of treatment, and therapeutic drug concentration monitoring of vancomycin. Results Among 228 cases, male (143 cases, 62.72%) was more than female (85 cases, 37.28%). Department of orthopedics (73 cases, 32.02%) and Department of neurosurgery (32 cases, 14.04%) had higher vancomycin usage ratio. 195 Cases of microbiological samples (85.53%) were detected, and main of pathogenic bacteria were Staphylococcus aureus (26 cases, 35.62%) and Staphylococcus epidermidis (15 cases, 20.55%). Among 228 cases, there were 193 cases (84.65%) for intravenous administration, and 156 cases (68.42%) with dosage of 2 g/d, and 144 cases (63.16%) with course of treatment less than 7 d. A total of 39 cases (31.70%) blood drug concentration were monitored and 15 cases trough concentration remained at 10-20 mg/L. Conclusion The use of vancomycin in Tianjin Baodi People's Hospital is basically rational, it's necessary to pay more attentions to serum concentration monitoring to ensure the drug safety of patients.

R969.3