CAJ | 학술논문

目的：调查某院肿瘤患者围手术期预防应用抗菌药物的合理性，为抗菌药物的合理应用和管理提供依据。方法回顾性调查分析2012年7月~2013年6月某院316例肿瘤手术患者的病历资料，按抗菌药物在围手术期预防应用指南等相关标准，对围手术期抗菌药物预防性应用的合理性进行评价。结果Ⅰ类切口手术抗菌药物预防性使用率为63.0％，Ⅱ类切口手术抗菌药物预防性应用率92.4％；其中使用频度最高的是头孢哌酮舒巴坦钠；用药疗程24～48 h（感染率5.36％），3～7 d（感染率4.69％），>7 d（感染率19.57％），用药疗程一周以内术后的感染率无显著性差异（P>0.05），使用一周以后感染率显著高于一周内（P<0.05）。主要存在的问题有：预防用药指征把握不严、药物选择不当、用药时机不对、术后用药时间较长、用法用量不合理等。结论某院肿瘤患者围手术期抗菌药物预防应用仍存在不合理现象，需制定完善的围手术期预防用药管理措施，确保安全合理用药。
목적：조사모원종류환자위수술기예방응용항균약물적합이성，위항균약물적합리응용화관리제공의거。방법회고성조사분석2012년7월~2013년6월모원316례종류수술환자적병력자료，안항균약물재위수술기예방응용지남등상관표준，대위수술기항균약물예방성응용적합이성진행평개。결과Ⅰ류절구수술항균약물예방성사용솔위63.0％，Ⅱ류절구수술항균약물예방성응용솔92.4％；기중사용빈도최고적시두포고동서파탄납；용약료정24～48 h（감염솔5.36％），3～7 d（감염솔4.69％），>7 d（감염솔19.57％），용약료정일주이내술후적감염솔무현저성차이（P>0.05），사용일주이후감염솔현저고우일주내（P<0.05）。주요존재적문제유：예방용약지정파악불엄、약물선택불당、용약시궤불대、술후용약시간교장、용법용량불합리등。결론모원종류환자위수술기항균약물예방응용잉존재불합리현상，수제정완선적위수술기예방용약관리조시，학보안전합리용약。
Objective To investigate the rationality of perioperative prophylactic use of antibacterial agents for tumor patients in a hospital, and offer evidence for reinforcing the rational use and standard management of antibacterial agents. Methods Ac-cording to the application guide of prophylactic antibacterial agents in perioperative period and the relevant standards, the medical records of 316 patients with tumor surgery between July 2012 and June 2013 were retrospectively reviewed and analyzed, and their application rationality of antibacterial agents in perioperative period were evaluated. Results The utilization rate of preven-tive antibacterial agents is 63.0%in the patients with typeⅠincision, and is 92.4%in the patients with typeⅡ incision. Among those antibacterial agents, the frequency of use of cefoperazone sulbactam is the highest. The percent of infection after operation in 24~48 h, 3~7 d and>7 d group were 5.36%, 4.69%and 19.57%respectively. No difference of infection percents was found between 24~48 h and 3~7 d group (P>0.05). The percent of infection in>7 d group was higher than in 24~48 h or 3~7 d group (P<0.05). The main problems such as not confirming medication indicator, improper drug selection, inappropriate time of initial administration, prolonged application, irrational use in dosage and administration exist in the perioperative prophylactic use of antibacterial agents. Conclusion There were unreasonable applications of preventive antibacterial agents to patients of tumor surgery perioperation period. It is suggested to intensify supervision and regulate the rational use of antibacterial agents.