骨科关节置换手术围手术期抗菌药物应用调查

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骨科关节置换手术围手术期抗菌药物应用调查

作者：宋劲亭 张革红

来源：《中国卫生产业》2017年第08期

[摘要] 目的 研究山西省人民医院骨科关节置换手术患者围手术期抗菌药物的使用情况。方法 对2014年11月—2016年11月出院的216例关节置换手术患者基本信息及围手术期经静脉给予抗菌药物的应用情况进行调查分析。结果 被调查者中全髋关节置换术154例，构成比为71.30%。有91.67%的患者在术前0.5～2 h进行抗菌药物预防性给药。围手术期使用的抗菌药物中第一代头孢菌素使用率最高，占47.22%；其次为林可胺类，占25.00%。其中单联用药167例，占77.31%。 结论 该院骨科关节置换手术围手术期预防性使用抗菌药物存在不合理现象，主要为选药档次 过高、联合用药等，应加强外科手术预防性使用抗菌药物的管理，进一步规范抗菌药物的合理应用。

[关键词] 骨科；关节置换手术；围手术期；抗菌药

[中图分类号] R978.1 [文献标识码] A [文章编号] 1672-5654（2017）03（b）-0005-02 [Abstract] Objective To research the use of antibacterials of knee replacement surgery in the department of orthopaedics during the perioperative period. Methods The basic information of 216 cases of discharged patients with knee replacement surgery from November 2014 to November 2016 were surveyed and the application of antibacterials by vein during the perioperative period was analyzed. Results There were 154 cases of patients with replacement of total hip， accounting for 71.30%， 91.67 percent of patients were given the preventive administration of antibacterials at 0.5～2 h before operation， and the usage rate of first generation cephalosporin during the perioperative period was the highest， accounting for 47.22%， the second was lincosamides， accounting for 25.00%， and there were 167 cases with single-linkage medication， accounting for 77.31%.

Conclusion The preventive use of antibacterials of the knee replacement surgery in the department of orthopaedics during the perioperative period is irrational， and the main manifestations are the exorbitant drug selection level and combined medication et al， and we should enhance the

management of preventive use of antibacteirals and further standardize the rational application of antibacterials.

[Key words] Department of orthopaedics； Knee replacement surgery； During the perioperative period； Antibacterials

伴随着人口步入老龄化以及医疗技术水平的发展，关节置换手术在骨外科治疗领域中广泛开展， 关节置换术后感染是最为严重的并发症之一。一旦发生感染，住院时间延长、治疗费用增加，严重者可能面临再次手术，给患者术后功能康复造成不利影响[1]。关节置换手术围