精神科住院患者院内感染现状及抗菌药物使用情况分析

盛永慧，张晓侠，周海英，高勇，陈建平

山东省精神卫生中心，山东济南250014

精神科住院患者院内感染现状及抗菌药物使用情况分析

盛永慧，张晓侠，周海英，高勇，陈建平

山东省精神卫生中心，山东济南250014

目的调查精神科住院患者院内感染及抗菌药物使用情况，为加强精神病专科医院合理使用抗菌药物提供参考。方法对2015年1—12月上报医院内感染人数及全年使用抗菌药物186例进行回顾性分析。结果共上报医院感染患者151例，院内感染率为3.99%。2015年度出院患者3 785例中，使用抗菌药物186例，抗菌药物使用率为4.91%；使用抗菌药物共计10种，居前3位的依次为青霉素类、头孢菌素类、硝基呋喃类。其中治疗用药174例（93.54%），预防用药12例（6.45%），在药物分级方面，181例均使用非限制性药物，用药剂量、用药疗程等方面符合药品说明书的规定。在186例抗菌药物使用中，部分病例存在无指征用药、用药途径不当及用药疗程不足、病原学送检率过低等。结论该院住院患者院内感染率、抗菌药物例使用率、使用抗菌药物种类均符合有关规定，但在用药指征、途径、疗程、病原学送检率低等方面还存在不足。

精神科；院内感染；抗菌药物；合理使用

［Abstract］Objective To survey the hospital infection status and use situation of antimicrobial drugs of inpatients in the department of psychiatry and provide reference for enhancing the rational use of antimicrobial drugs in the psychiatric hospital.Methods 186 cases of patients with hospital infection and whole-year use of antimicrobial drugs reported from January 2015 to December 2015 were retrospectively analyzed.Results 151 cases with hospital infection were reported，and the hospital infection rate was 3.99%，in 2015，there were 186 cases using the antimicrobial drugs in all the discharged patients of 3785，and the use rate of antimicrobial drugs was 4.91%，there were 10 kinds of antimicrobial drugs in total，and the top three were in turn penicillins，cephalosporins and nitrofurans，among them，174 cases were with treatment medication，accounting for 93.54%，and 12 cases were with predictive medication，accounting for 6.45%，in terms of drug classification，181 cases used the non-restrictive drugs，the medical dose and treatment course met the specification of drug instruction，and in the use of 186 cases of antimicrobial drugs，no sign medication，inappropriate medication route and insufficient medication treatment course and excessively low etiology submission rate existed in some cases.Conclusion The hospital infection rate，use rate of antimicrobial drugs and antimicrobial drug use kind meet the related specification，but there are still shortcomings in the medication sign，route，treatment course and etiology submission rate.

［Key words］Department of psychiatry；Hospital infection；Antimicrobial drugs；Rational use

院内感染是指住院病人在医院内获得的感染，包括在住院期间发生的感染和在医院内获得出院后发生的感染。控制医院感染是现代化医院管理的重要组成部分。近年来，我国卫生行政部门多次规定并提出，预防院内感染是衡量医院管理水平的重要指标之一，是各级医院领导和医务人员的重要职责，也是进行医院医疗质量检查和评审的主要指标。……