【摘要】 目的 探讨基于属性层次模型（AHM）的骨科关节置换术（包括膝关节置换和髋关节置换）预防性使用抗菌药物合理性评价标准，为该类手术抗菌药物预防使用提供参考。方法 参考《抗菌药物临床应用指导原则（2015版）》、《桑德福抗微生物治疗指南（48版）》、相关药品说明书及国内外治疗指南等，制定基于AHM的关节置换术预防性使用抗菌药物合理性评价标准，并据此对2021年1月至2021年12月安徽医科大学安庆医学中心208例行关节置换术的患者病历的围手术期抗菌药物使用情况进行分析。结果 关节置换术预防性使用抗菌药物主要不合理类型涉及头孢菌素皮试（65.87%）、用药疗程（61.06%）、给药剂量（53.37%）、药物选择（26.92%）；病历评分（MRS）≥90分的41例（19.71%）,80分≤MRS<90分的67例（32.21%）,60分≤MRS<80分的87例（41.83%）,MRS<60分的13例（6.25%）。结论 安徽医科大学安庆医学中心骨科关节置换术围手术期抗菌药物使用较为合理，但在药物选择、给药剂量、用药疗程、头孢菌素皮试等方面存在不合理用药，需进一步规范。更多还原

【Abstract】 Objective To explore the rational evaluation criteria for the prophylactic use of antibiotics in orthopedic joint replacement(including knee replacement and hip replacement) based on the attribute hierarchical model(AHM) to provide a reference for the prophylactic use of antibiotics in this surgery. Methods According to the Guidelines of Clinical Use of Antimicrobial Agents(2015 edition), the Sanford Guide to Antimicrobial Therapy(48th edition), relevant drug instructions and treatment guidelines at home and abroad, the reasonable evaluation criteria for the prophylactic use of antibiotics in joint replacement based on AHM was developed. The perioperative use of antibiotics in 208 patients undergoing joint replacement from January 2021 to December 2021 in Anqing Medical Center of Anhui Medical University was analyzed accordingly. Results The main unreasonable types and proportions of prophylactic use of antibiotics in orthopedic joint replacement were cephalosporin skin test(65.87%), course of medication(61.06%), dosage(53.37%) and drug selection(26.92%). Of all the patients, 41(19.71%) had a medical record score(MRS)≥90, 67(32.21%) had a score of 80≤MRS<90, 87(41.83%) had a score of 60≤MRS<80 and 13(6.25%)had a MRS<60. Conclusion The perioperative use of antibacterial drugs during orthopedic joint replacement in Anqing Medical Center of Anhui Medical University is relatively reasonable, but there is unreasonable medication need to be further standardized in terms of drug selection, dosage, course of medication and cephalosporin skin test.更多还原