目的 調(diào)查成都市公共衛(wèi)生臨床醫(yī)療中心HIV感染患者在Ｉ類切口手術(shù)中抗菌藥物的使用情況，分析其用藥合理性。方法 選取成都市公共衛(wèi)生臨床醫(yī)療中心2012年1月—2015年8月接受Ｉ類切口手術(shù)的218份感染HIV患者的病歷進行回顧性調(diào)查分析。結(jié)果 218份病例中預(yù)防使用抗菌藥物的有138例，其中以第1代頭孢菌素為主；用藥時間基本（98.55%）在術(shù)前30 min，手術(shù)時間超過3 h術(shù)中均追加一劑抗菌藥物；用藥療程小于48 h的占77.58%；術(shù)后6例切口部位感染，10例并發(fā)肺部感染。CD⁴⁺值與術(shù)后感染率呈反比，同時預(yù)防性使用抗菌藥物后，切口感染發(fā)生率為2.75%。結(jié)論 成都市公共衛(wèi)生臨床醫(yī)療中心抗菌藥物使用情況基本合理，但仍存在選藥不合理，給藥時機不恰當，用藥時間偏長的問題。需要采取相應(yīng)的干預(yù)措施，規(guī)范圍手術(shù)期預(yù)防抗菌藥物的使用。

Objective To investigate the usage of antibiotics in patients with HIV-infection undergoing type I incision surgery in Public Health Clinical Center of Chengdu, and to analyze the rationality of drug use.Methods Records (218 cases) of patients with HIV-infection undergoing type I incision surgery in Public Health Clinical Center of Chengdu from January 2012 to August 2015 were reviewed retrospectively. Results There were 138 cases of prophylactic application of antibiotics in 218 medical records. Most of antibiotics were first - generation cephalosporins. The application time of most antibiotics (98.55%) was 30 min before surgery. When the operation lasted more than 3 h, the patients were received additional medication. The constituent ratio of the course of treatment that was less than 48 h was 77.58%. There were 6 cases of surgical site infection, and 10 cases of concurrent pulmonary infection. The number of CD⁴⁺ was negatively correlated with postoperative infection, and the incidence of incision infection was 2.75%. Conclusion The use of antibiotics in Public Health Clinical Center of Chengdu is basically rational, but the problems such as the irrationality of drug choosing, inappropriate time, or long time of drug use still existed. The relative intervention measures are needed to guard the perioperative prophylactic application of antibiotics.

四川省醫(yī)學會重癥醫(yī)學（國瑞）專項科研課題（2015ZZ006(GR）