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| 儿科Ⅱ类切口手术预防性抗菌药物使用现状与合理性分析:基于1 790 例病例的回顾性研究 |
| 丁臻1,周宬玥1,姚奇1,刘彦会1,吴进进1,王钦1,徐小倩1,王卓芸1,蔡和平1,王晓玲2 |
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| (1. 安徽省儿童医院,合肥 230001;2. 首都医科大学附属北京儿童医院,北京 100010) |
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| 摘要: |
| 目的:评估安徽省儿童医院儿科Ⅱ类切口手术预防性抗菌药物的使用现状与合理性,为围术期用药的精细化管理提供参考。方法:采用回顾性研究方法,调取该院2024 年出院且切口等级为Ⅱ类的手术病例1 790 例。依据《抗菌药物临床应用指导原则(2015 年版)》等标准,评价其预防用药的品种选择、给药时机及疗程等关键环节的合理性。结果:1 790 例手术主要分布于耳鼻喉科(49. 33%)、泌尿外科(18. 21%)及普外科/ 新生儿外科(12. 40%)。预防用药以第一代、第二代头孢菌素为主(合计占70. 62%),头孢唑林钠使用最多(49. 50%)。给药时机合理率为89. 94%,但用药疗程合理率仅为37. 82%,62. 18%的病例疗程>24 h。部分科室存在预防用药品种选择级别偏高现象。结论:该院儿科Ⅱ类切口手术预防用药的给药时机控制规范,但用药疗程过长问题极为突出。应将“缩短用药疗程与规范重点科室选药”作为优先改进目标,并制定儿科专属的用药管理策略。 |
| 关键词: 儿科 Ⅱ类切口手术 抗菌药物 预防性使用 合理用药 回顾性研究 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2026.04.001 |
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| 基金项目:国家卫生健康委能力建设和继续教育中心2025 年度专项研究(儿科和药学方向)课题,编号GWJJZX20251004010。 |
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| Current Status and Rationality Analysis of Prophylactic Use of Antibiotics in Pediatric Type Ⅱ Incision Surgery: a Retrospective Study Based on 1,790 Cases |
| Ding Zhen1, Zhou Chengyue1, Yao Qi1, Liu Yanhui1, Wu Jinjin1, Wang Qin1, Xu Xiaoqian1, Wang Zhuoyun1, Cai Heping1, Wang Xiaoling2 |
| (1. Anhui Children’s Hospital, Hefei 230001, China; 2. Beijing Children’s Hospital, Capital Medical University, Beijing 100010, China) |
| Abstract: |
| Objective: To evaluate the current status and rationality of prophylactic use of antibiotics in pediatric type Ⅱ incision surgery in Anhui Children’s Hospital, and to provide reference for the refined management of perioperative medication. Methods: A retrospective study was performed, and 1,790 surgical cases with type Ⅱ incision from the hospital that were discharged in 2024 were retrieved. The rationality of key aspects such as prophylactic drug selection, administration timing, and duration was assessed based on standards like the Guiding Principles of Clinical Use of Antibiotics (2015 Edition). Results: The 1,790 surgical cases were primarily distributed across the Department of Otolaryngology ( 49. 33%), Urology ( 18. 21%), and General Surgery/ Neonatal Surgery (12. 40%). Prophylactic drugs were predominantly the first- and second-generation cephalosporins (accounting for 70. 62% of total), with cefazolin sodium being the most frequently used (49. 50%). The rationality rate of administration timing was 89. 94%, while the rationality rate of medication duration was only 37. 83%. Totally 62. 18% of the cases had a treatment duration of more than 24 h. There was a phenomenon of high-level selection of prophylactic drugs in some departments. Conclusion: The administration timing of prophylactic medication for pediatric type Ⅱ incision surgery of the hospital is well controlled, but the issue of excessively long medication duration is extremely prominent. Shortening treatment courses and standardizing the selection of drugs in key departments should be prioritized as improvement targets, and a pediatric-specific medication management strategy should be formulated. |
| Key words: Pediatrics type Ⅱ incision surgery antibiotics prophylactic use rational medication retrospective study |
