摘要:目的：評價圍手術期預防性應用抗菌藥物現狀及合理性。方法：采用回顧性調查的方法，隨機抽查2009年度Ⅰ類切口手術圍手術期病案500份，設計外科圍手術期預防性應用抗生素調查表，對預防用藥的適應證、用藥種類、聯合用藥、給藥時機及持續時間進行統計分析。結果：未使用抗生素5例，預防性使用抗生素495例，其中不合理80例（16.00％）。預防性使用抗生素總品規數為540，其中頭孢菌素類453例（83.89%），青霉素類（包括加酶抑制劑）26例（4.81%），喹諾酮類44例（8.15%）。選用頭孢唑啉鈉178例（32.96%）居第一位，頭孢替唑鈉第二，151例（2796%）。結論：Ⅰ類切口手術患者圍手術期預防性使用抗菌藥物較為合理，但仍存在用藥指征把握不嚴，抗菌藥物的選擇、抗菌藥物使用時間較長等問題，有待進一步規范化管理。Abstract: Objective: To understand the current application of perioperative preventive antibiotics, and their rationality. Methods: Five hundred perioperative records of patients with incision Ⅰ were randomly chosen and surveyed in 2009. A questionnaire for prophylactic use of antimicrobial was designed. The indication of antimicrobial use, the species, combination, timing and drug duration were analyzed. Results: Our of 500, 495 used antimicrobial and 80 were unreasonable; 540 kinds of antimicrobial were used, included cephalosporin 453 cases (83.89%), penicillin class (including plus enzyme inhibitors) in 26 cases (4.81%), quinolone 44 cases (8.15%). Cefazolin sodium (178 patients, 32.96%) ranked first, second was cefazolin sodium (151, 27.96%). Conclusion: Perioperative use of antimicrobial prophylaxis in patients with incision Ⅰ is reasonable, but standardization management should be strengthened in the indication, species, and duration.
Objective To understand the situation and technical level of aeromedical rescue in medical institutions in Qinling-Daba mountainous area. Methods A questionnaire survey was conducted on the staff of medical institutions of the medical consortium of Renmin Hospital of Hubei University of Medicine, located in Qinling-Daba mountainous area between June and September 2023. The basic information and development, demand, and knowledge mastery of aeromedical rescue were investigated. Results A total of 45 medical institutions participated in the research, 500 questionnaires were sent out, and 479 valid questionnaires were recovered, with an effective rate of 95.8%. Among them, there were 7 tertiary hospitals, 23 secondary hospitals, and 15 township health institutions; 11 medical institutions had participated in aeromedical rescue, and 17 hospitals had participated in aerial rescue drills. The survey subjects were mainly from emergency departments and intensive care medicine departments, women, aged>30 and ≤40 years old, undergraduate students, intermediate professional titles, and doctors. Twenty-one medical workers had received formal training in aeromedical rescue skills, 77 had received short-term theoretical and practical training, 123 had participated in short-term simulation exercises, and 93 had participated in aeromedical rescue activities. There was a statistically significant difference among the scores of first aid knowledge, aviation flight knowledge, and aeromedical rescue knowledge (9.34±0.35 vs. 4.65±2.91 vs. 3.28±3.44; F=15.048, P=0.001). There were statistically significant differences between first aid knowledge and aviation flight knowledge, as well as between first aid knowledge and aeromedical rescue knowledge (P<0.05). There was no statistically significant difference between aviation flight knowledge and aeromedical medical rescue knowledge (P>0.05). Conclusion There is an urgent demand for aviation rescue in medical institutions in Qinling-Daba mountainous area, and there is a shortage of professionals, so it is necessary to strengthen the training, rehearsal and practice of aeromedical rescue.