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目的:了解荆门地区医院腹外疝围术期预防用抗菌药物情况。方法:回顾性整群抽取荆门地区2011年19家医院(三级医院2所,二级医院8所,一级医院9所)腹外疝手术患者病历768份,对围术期抗菌药物应用率、抗菌药物选用频度、病原学送检率、首剂给药时间、平均给药疗程和联合用药情况进行统计、分析。结果:抗菌药物应用率三级医院达70.6%,二级医院达92.4%,一级医院达100%;人均用药种类为三级医院1.03种,二级医院1.15种,一级医院1.55种;病原学送检率三级医院为28.7%,二级医院为13%,一级医院为8.8%;首剂给药时机合理率三级医院为40.2%,二级医院为33.2%,一级医院为10%;平均给药疗程三级医院为3.5d,二级医院为4.7d,一级医院为6.2d;联合用药比例三级医院为10.1%,二级医院为31.8%,一级医院为65.9%。结论:各级医院腹外疝围术期均存在不合理应用抗菌药物的情况,二级、一级医院更为严重,亟待加强监管。
Objective: To understand the perioperative prevention of antimicrobial agents in abdominal hernia in Jingmen area hospital. Methods: A total of 768 medical records were collected from 19 hospitals (2 hospitals of tertiary hospitals, 8 hospitals of secondary hospitals and 9 hospitals of primary hospitals) in Jingmen area in retrospective cluster. The application rate of perioperative antibacterials , The frequency of antibacterials selection, the rate of etiological examination, the time of the first dose, the average course of treatment and the combination of drugs were statistically analyzed. Results: The utilization rate of antimicrobial agents was 70.6% in tertiary hospitals, 92.4% in secondary hospitals and 100% in primary hospitals. The average per capita drug use was 1.03 for tertiary hospitals, 1.15 for secondary hospitals and 1.55 for primary hospitals. The rate of the third-grade hospital was 28.7%, the second-class hospital was 13% and the first-grade hospital was 8.8%. The first-dose administration rate was 40.2% at the third-level hospital and 33.2% at the second-level hospital. The first- 10%; the average course of treatment was 3.5d for tertiary hospitals, 4.7d for secondary hospitals and 6.2d for primary hospitals; 10.1% for tertiary hospitals, 31.8% for secondary hospitals and 65.9 for primary hospitals %. CONCLUSION: There are unreasonable use of antibacterials in the perioperative period of hernia in hospitals at all levels. The second-tier and first-tier hospitals are even more serious, and supervision is urgently needed.