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目的:了解骨科Ⅰ类切口手术围术期预防性应用抗菌药物的合理性情况,为规范围术期预防性用药提供参考。方法:采用回顾性调查分析方法,抽取南昌市第三医院(以下简称“我院”)318例骨科Ⅰ类切口手术患者的病历资料,对预防性应用抗菌药物的合理性进行统计分析。结果:我院骨科Ⅰ类切口手术围术期抗菌药物预防性使用率为90.88%(289/318)。289例预防性用药患者中,术前2 h给药率为99.31%(287/289);抗菌药物选择合理率为98.96%(286/289);用药疗程合理率为83.04%(240/289);预防性用药时间>48 h患者所占比例为14.53%(42/289);手术时间>3 h者63例、失血量>1 500 ml者6例(其中上述2种情况同时出现的有2例),仅13例患者术中追加抗菌药物。结论:我院骨科Ⅰ类切口手术围术期抗菌药物预防性使用率较高,预防性用药时间>48 h患者所占比例也较高,术中追加率偏低,有待今后持续改进。
OBJECTIVE: To understand the rationality of prophylactic use of antibacterials during the perioperative period of type Ⅰ incision in orthopedics and to provide reference for the prevention of perioperative prophylaxis. Methods: A retrospective investigation was conducted to collect the medical records of 318 orthopedic patients with type Ⅰ incision in the Third Hospital of Nanchang (hereinafter referred to as “our hospital”), and to analyze the rationality of prophylactic use of antibacterials. Results: The prophylactic use rate of antibacterials in Class Ⅰ incision in orthopedics was 90.88% (289/318) in our hospital. Among the 289 prophylactic patients, the rate of preoperative 2 h was 99.31% (287/289), the rate of antibacterials was 98.96% (286/289), and the rate of medication was 83.04% (240/289) ; Preventive medication time> 48 h patients accounted for 14.53% (42/289); operation time> 3 h in 63 cases, blood loss> 1 500 ml in 6 cases (of which the above two cases occur simultaneously with 2 Cases), only 13 cases of patients additional antibiotics. CONCLUSION: The preventive rate of antimicrobial agents used in Class Ⅰ incision in orthopedic surgery in our hospital is high, and the prophylactic treatment time is higher than 48 h. The additional rate during operation is low and needs further improvement in the future.