摘要
目的:分析妇科手术预防用抗菌药物的使用情况,为进一步规范抗菌药物合理应用提供参考。方法:对某院2019年7月至2019年12月妇科围术期抗菌药物的应用进行回顾性调查,结合中华医学会妇产科学会、美国妇产科医师学会(American College of Obstetricians and Gynecologists, ACOG)、加拿大妇产科医师协会(Society of Obstetricians and Gynecologists of Canada, SOGC)、法国国家妇产科医师协会(Collège National des Gynécologues et Obstétriciens Francais, CNGOF)等学术机构制定的专科指南对用药情况进行评价,运用描述统计法进行分析。结果:共调取337份病例,分类为宫腔镜手术(Ⅰ组,n=127),腹腔镜手术(Ⅱ组,n=46),宫颈组织切除术(Leep、活组织检查、子宫颈刮宫术)/扩宫和刮宫术(Ⅲ组,n=13),人工流产-刮宫术、引产术(Ⅳ组,n=144),阴道前后壁修补术/子宫切除术(Ⅴ组,n=7)。抗菌药物使用率高达100.00%,无指征用药140例(41.54%),用药时机不合理299例(88.72%),用药疗程不合理192例(56.97%),用药品种不合理55例(16.32%)。在腹腔镜和宫腔镜手术预防用药上,国内指南未明确规定,本研究主要参考ACOG、SOGC等机构指南。结论:该院妇科围术期抗菌药物不合理用药现象较严重,主要为无指征用药和用药时机不合理,临床药师应采取干预措施以促进合理用药。
OBJECTIVE To explore the use of prophylactic antibiotics during gynecological operations and provide rationales for further standardizing the rational use of antibiotics.METHODS A retrospective survey was conducted for using prophylactic antibacterial drugs during gynecological operations from July to December 2019. The descriptive statistical method was employed. The use of antibiotics was evaluated according to the guidelines of Society of Obstetrics and Gynecology of Chinese Medical Association, American College of Obstetricians and Gynecologists(ACOG), Society of Obstetricians & Gynecologists of Canada(SOGC) and College National Des Gynecologues Etobstetriciens Francais(CNGOF).RESULTS A total of 337 cases were recruited and classified into the groups of hysteroscopy(Ⅰ, n=127), laparoscopy(Ⅱ, n=46), cervical tissue excision(LEEP, biopsy, endocervical curettage)/dilation & curettage(Ⅲ, n=13), pregnancy termination/dilation & evacuation/labor induction(Ⅳ, n=144) and hysterectomy/anteroposterior wall colporrhaphy(Ⅴ, n=7). The utilization rate of antibiotics was 100.00%. There were 140 cases(41.54%) without indications, 299 cases(88.72%) with unreasonable timing, 192 cases(56.97%) with unreasonable course of treatment and 55 cases(16.32%) with unreasonable drug varieties. Regarding antibiotic prophylaxis of laparoscopy and hysteroscopy, the domestic guidelines were poorly defined and this study referred to the guidelines of ACOG, SOGC and other institutions.CONCLUSION Irrational prophylactic applications of antibiotics are rampant at hospitals. The major causes are inappropriate timing of medication and loose adherence to indications. Clinicians should take effective and feasible measures for promoting rational drug usage.
作者
杨燕
黄健
张展涛
刘平
钟达通
潘晓君
郑治清
YANG Yan;HUANG Jian;ZHANG Zhan-tao;LIU Ping;ZHONG Da-tong;PAN Xiao-jun;ZHENG Zhi-qing(Department of Pharmacy,Dapeng Maternal&Child Health Hospital,Dapeng New District,Guangdong Shenzhen 518000,China)
出处
《中国医院药学杂志》
CAS
北大核心
2021年第5期437-441,449,共6页
Chinese Journal of Hospital Pharmacy
关键词
抗菌药物
妇科手术
药物使用评价
指南共识
antibacterial drugs
gynecological operations
drug-use evaluation
guideline and consensus
