目的 探討干預(yù)前后荊門地區(qū)剖宮產(chǎn)圍術(shù)期抗菌藥物的使用合理性。方法 回顧性調(diào)查荊門市二級以上醫(yī)院2 527患者剖宮產(chǎn)圍術(shù)期抗菌藥物的應(yīng)用情況，按照干預(yù)時段分為干預(yù)前組（2017年1~12月，1 186例患者）與干預(yù)后組（2018年1~12月，1 341例患者）。對兩組剖宮產(chǎn)圍術(shù)期抗菌藥物品種選擇、給藥時機(jī)、用法用量、用藥療程等情況進(jìn)行對比分析。結(jié)果 干預(yù)后，抗菌藥物的使用合理率由72.31%上升到88.95%。對于注射用頭孢唑啉、注射用頭孢他啶和甲硝唑氯化鈉注射液，干預(yù)前組均采用2次/d給藥方式，干預(yù)后組均采用1次/8 h給藥方式。干預(yù)前預(yù)防用藥療程普遍較長，術(shù)后用藥時間超過72 h者占29.5%，≤ 24 h者僅占21.8%。干預(yù)后，術(shù)后用藥時間≤ 24 h者上升至47.9%。結(jié)論 通過持續(xù)性藥師干預(yù)，荊門地區(qū)剖宮產(chǎn)圍術(shù)期抗菌藥物應(yīng)用的合理性顯著改善，干預(yù)效果明顯。

Objective To analyze the rationality of antibiotics in the perioperative period of cesarean section in Jingmen area before and after the intervention. Methods A retrospective investigation was performed on rationality of antibiotics in 2 527 patients who had cesarean section in Jingmen second-level hospital or above. According to the time of intervention, the patients were divided into pre-intervention group (control group, 1 186 cases, between January and December 2017) and post-intervention group (1 341 cases, between January and December 2018). Choice of antibiotic species, timing of administration, usage and dose, and course of treatment were analyzed. Results After the intervention, the rational rate of antibiotics was risen from 72.31% to 88.95%. For Cefazolin for Injection, Ceftazidime for Injection, and Metronidazole Sodium Chloride Injection, the dosing frequency were twice daily before the intervention and once/8 h after the intervention. The duration of prophylactic medication was generally long, and the rate of postoperative medication duration above 72 h was 29.5%, while the rate of that ≤ 24 h was only 21.8% before the intervention. After the intervention, the rate of postoperative medication duration ≤ 24 h was increased to 47.9%. Conclusion Rational use of antibiotics during perioperative period of cesarean section in Jingmen area can be significantly improved through continued intervention.

R978.1

荊門市科學(xué)技術(shù)研究與開發(fā)計(jì)劃引導(dǎo)項(xiàng)目（2019YDKY060）