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| 儿科Ⅰ类切口围术期抗菌药物预防使用现状与认知度调查及管理策
略探讨 |
| 袁丽华1,孙川1,孙尧1,杨丹丹1,胡天骄1,陈峰1,徐进1,王晓玲2 |
| ((1. 南京医科大学附属儿童医院,南京 210008;2. 首
都医科大学附属北京儿童医院,北京 100045)) |
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| 摘要: |
| 目的:探究在儿科Ⅰ类切口手术预防用药整体规范背景下的终末环节结构性不合理问题,为抗菌药物管理向精准化、循
证化决策转型提供参考。方法:采用解释性序列混合方法设计,通过定性与定量数据互补分析Ⅰ类切口抗菌药物使用现状。
结果:临床实践与指南的核心差距为疗程管控;医生整体认知良好,仅16. 08%不认同术后24 h 停药,且集中于心胸外科等高风
险手术科室。单中心管控成效显著,预防用药率从19. 82%降至15. 37%,24 h 停药率从91. 80%升至98. 49%,切口感染率仅
0. 12%;疗程>72 h 的不合理用药病例分布,与问卷调研得出的认知偏差科室分布高度一致。结论:儿科Ⅰ类切口手术预防用药
不规范问题已得到显著改善,仅少数高风险手术存在疗程过长的突出问题。管理重心需转向高风险手术的精细化、循证化、智
能化管控,通过建立精准目录、开展专项研究等,推动抗菌药物管理质量进阶与可持续改进。 |
| 关键词: 儿科 Ⅰ类切口手术 抗菌药物预防使用 现状 合理用药 管理对策 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2026.07.005 |
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| 基金项目: |
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| Investigation on Current Status and Awareness of Preoperative Antibiotic Prophylaxis for Pediatric Class ⅠIncision Surgery and Discussion on Management Strategies |
| Yuan Lihua1, Sun Chuan1, Sun Yao1, Yang Dandan1, Hu Tianjiao1, Chen Feng1, Xu Jin1, Wang Xiaoling2 |
| ((1. Children’s Hospital of Nanjing Medical University, Nanjing 210008, China; 2. Beijing Children’ s Hospital, Capital Medical
University, Beijing 100045, China)) |
| Abstract: |
| Objective: To explore the structural irrational practices of terminal link under the background of overall standardization of
preventive medication in pediatric class I incision surgery, and to provide reference for the transformation of antimicrobial management to
precision and evidence-based decision-making. Methods: The explanatory sequential mixed-methods design was adopted. Through the
complementary analysis of qualitative and quantitative data, the current situation of antibacterial use for class I incision was investigated.
Results: The primary divergence between practice and guidelines was treatment duration. Physicians demonstrated generally high
awareness: only 16. 08% opposed postoperative discontinuation at 24 h, with these dissenting views concentrated in high-risk surgical
specialties such as Cardiothoracic Surgery. Single-center interventions produced notable improvements, prophylactic antibiotic use fell
from 19. 82% to 15. 37%, timely discontinuation at 24 h rose from 91. 80% to 98. 49%, and the surgical site infection rate was 0. 12%.
Cases of irrational antibiotic use >72 h were spatially and departmentally aligned with the cognitive biases identified in the questionnaire.
Conclusion: Irregular use of prophylactic antibiotics in pediatric class I incision surgery has been markedly improved. However,
excessive treatment courses persist mainly in a small subset of high-risk procedures. Management should shift toward refined, evidencebased,
and intelligent oversight focused on those high-risk surgeries. Developing targeted medication formularies and conducting focused
researches could promote continual quality improvement in antimicrobial management. |
| Key words: Pediatrics class I incision surgery antimicrobial prophylaxis current status rational drug use management strategy |
