目的 探讨干预前后荆门地区剖宫产围术期抗菌药物的使用合理性。方法 回顾性调查荆门市二级以上医院2 527患者剖宫产围术期抗菌药物的应用情况，按照干预时段分为干预前组（2017年1~12月，1 186例患者）与干预后组（2018年1~12月，1 341例患者）。对两组剖宫产围术期抗菌药物品种选择、给药时机、用法用量、用药疗程等情况进行对比分析。结果 干预后，抗菌药物的使用合理率由72.31%上升到88.95%。对于注射用头孢唑啉、注射用头孢他啶和甲硝唑氯化钠注射液，干预前组均采用2次/d给药方式，干预后组均采用1次/8 h给药方式。干预前预防用药疗程普遍较长，术后用药时间超过72 h者占29.5%，≤ 24 h者仅占21.8%。干预后，术后用药时间≤ 24 h者上升至47.9%。结论 通过持续性药师干预，荆门地区剖宫产围术期抗菌药物应用的合理性显著改善，干预效果明显。

Objective To analyze the rationality of antibiotics in the perioperative period of cesarean section in Jingmen area before and after the intervention. Methods A retrospective investigation was performed on rationality of antibiotics in 2 527 patients who had cesarean section in Jingmen second-level hospital or above. According to the time of intervention, the patients were divided into pre-intervention group (control group, 1 186 cases, between January and December 2017) and post-intervention group (1 341 cases, between January and December 2018). Choice of antibiotic species, timing of administration, usage and dose, and course of treatment were analyzed. Results After the intervention, the rational rate of antibiotics was risen from 72.31% to 88.95%. For Cefazolin for Injection, Ceftazidime for Injection, and Metronidazole Sodium Chloride Injection, the dosing frequency were twice daily before the intervention and once/8 h after the intervention. The duration of prophylactic medication was generally long, and the rate of postoperative medication duration above 72 h was 29.5%, while the rate of that ≤ 24 h was only 21.8% before the intervention. After the intervention, the rate of postoperative medication duration ≤ 24 h was increased to 47.9%. Conclusion Rational use of antibiotics during perioperative period of cesarean section in Jingmen area can be significantly improved through continued intervention.

R978.1

荆门市科学技术研究与开发计划引导项目（2019YDKY060）