| 摘要: |
| ［摘要］ 目的 了解基层医院手术切口细菌分布与抗菌药物使用情况，为临床合理应用抗菌药物提供依据。方法 采用单盲方法，对某基层医院住院治疗的246例患者手术切口提取物进行细菌培养，对围手术期抗菌药物临床应用情况进行调查统计，与国家卫生部、中华医学会等制定的合理用药相关规定和有关文献资料进行比较分析。结果 246例患者手术切口检出病原菌79株，其中大肠埃希菌53株（67.09%），表皮葡萄球菌24株（30.38%），铜绿假单胞菌2株（2.53%）。医生对246例患者均不考虑手术切口类别而经验性使用了6类14种抗菌药物417例次，抗菌药物使用率100%，使用频次最多的是二代头孢菌素（50.60%）。大多数围手术期抗菌药物的使用存在无适应证用药、药物选择混乱、用药疗程过长、用药时间把握不准、载体溶媒配伍不当等问题。结论 基层医院手术切口感染的革兰阳性细菌主要是表皮葡萄球菌；目前围手术期抗菌药物的使用依然普遍不合理，应采取更为积极有效的刚性干预和监管措施，进一步促进抗菌药物临床合理应用。 |
| 关键词: 手术切口 病原菌 抗菌药物应用 比较分析 |
| DOI：10.3969/j.issn.1674-3806.2014.03.04 |
| 分类号:R 613 |
| 基金项目:广东省珠海市科技计划项目专项基金资助（编号：2012D0401990020） |
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| Comparison of bacterial distribution on surgical incision and antimicrobial application in basic-level hospitals |
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FAN Xian-wei，LIANG Ai-chan, LUO Hai-hui, et al.
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Department of Surgery，Hongqi Hospital of Zhuhai City，Guangdong 519090，China
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| Abstract: |
| ［Abstract］ Objective To know the bacterial distribution on surgical incision and antimicrobial application in primary hospital and provide the basis for clinical antibacterial drug application.Methods Bacterial culture was performed in 246 patients′ surgical incision treated in primary hospital by single blind, and recorded antimicrobial application in perioperative period,then compared and analyzed it with related regulations and reference from Chinese medical association and national hygiene department.Results Seventy-nine strains of pathogenic bacteria had been detected in 246 patients′ surgical incision, including 53 strains of E.coli(67.09%), 24 strains of Staphylococcus(30.38%) and 2 strains of pseudomonas aeruginosa(2.53%).The 246 patients used 6 class，14 kinds of antibacterial drugs，417 times without considering the surgical incision category, the usage rate of antibacterial drug was 100%,second generation cephalosporin was the most frequently used(50.60%), there were problems of without indications drugs,most of the perioperative use of antimicrobial medicine, chaotic medicine choices, too long medication,inaccurate medication time, and improper carrier solvent existed in the perioperative period of most antimicrobial application.Conclusion The main gram positive bacteria of surgical incision is epidermis staphylococcus in primary hospital;the antimicrobial application in perioperative period at present is still generally unreasonable, more effective intervention and supervision measures should be adopted,in order to further promote the reasonable antimicrobial application in clinic. |
| Key words: Surgical incision Pathogenic bacteria Antimicrobial application Comparative analysis |
