目的 通過對(duì)Ⅱ類切口手術(shù)患者抗菌藥物預(yù)防應(yīng)用情況的分析，以期引起臨床對(duì)Ⅱ類切口手術(shù)預(yù)防用藥合理性的關(guān)注。方法 對(duì)2019年出院的577例Ⅱ類切口手術(shù)患者的圍手術(shù)期預(yù)防性應(yīng)用抗菌藥物情況進(jìn)行回顧性分析，對(duì)抗菌藥物的品種選擇、給藥時(shí)機(jī)、用藥療程等指標(biāo)進(jìn)行分析與評(píng)價(jià)。結(jié)果 577例Ⅱ類切口手術(shù)患者全部預(yù)防性應(yīng)用抗菌藥物，品種選擇以頭孢菌素類和硝基咪唑類抗菌藥物為主，二聯(lián)用藥占比較高，主要見于剖宮產(chǎn)等婦產(chǎn)科手術(shù)；用藥時(shí)機(jī)以術(shù)前0.5～1 h和夾住臍帶后為主，術(shù)前>；1 h主要見于鼻內(nèi)窺鏡下多個(gè)鼻竇開窗術(shù)等耳鼻喉科手術(shù)；預(yù)防用藥時(shí)長(zhǎng)<48 h占比較高，其中腹腔鏡下卵巢病損切除術(shù)等婦科手術(shù)用藥時(shí)長(zhǎng)相對(duì)較長(zhǎng)，平均值超過4 d。結(jié)論 Ⅱ類切口手術(shù)預(yù)防用藥存在選擇廣譜抗生素進(jìn)行預(yù)防用藥、用藥時(shí)程過長(zhǎng)等不合理問題，需加強(qiáng)抗菌藥物預(yù)防性應(yīng)用的管理，提高用藥合理性。

Objective To analyze the prophylactic application of antibiotics in patients with type Ⅱ incision surgery in Liaoning Provincial People's Hospital, so as to arouse clinical attention to the rationality of prophylactic use of antibiotics in type Ⅱ incision surgery. Methods A retrospective analysis was made on the perioperative prophylactic application of antibiotics in 577 patients with type Ⅱ incision who were discharged from hospital in 2019. The evaluation and analysis were made on the selection of antibiotics, timing of antibiotics, and treatment course. Results All 577 patients with type Ⅱ incision surgery were treated with prophylactic antibiotics. Cephalosporins and Nitroimidazoles were the main antibiotics, and combination of two drugs accounted for a relatively high proportion, which was mainly used in obstetrics and gynecology surgery such as cesarean section. The timing of antibiotics was mainly 0.5-1 h before surgery and after cutting umbilical cord, and > 1 h before surgery was mainly used in byear, nose and throat (ENT) surgery such as antrostomy of multiple sinuses under nasal endoscope. The duration of medication<48 h was higher than that of other, gynecological surgery such as ovariectomy under laparoscopic, which has a mean of more than 4 days. Conclusion There are some irrational problems in the prophylactic application of antibiotics in type Ⅱ incision surgery such as the selection of broad-spectrum antibiotics, the long time course of use of antibiotics, etc. it is necessary to strengthen the management of prophylactic use of antibiotics and improve the rationality of use of antibiotics.

R978.1