1510例神经外科清洁手术预防性应用抗生素研究  

The research of prophylactic use of antibiotics in 1 510 cases of neurosurgical clean operations

作　　者：张晓硌[1] 沈明[1] 张楠[1] 乔霓丹[1] 裘慧佳[1] 王镛斐[1] 

机构地区：[1]复旦大学附属华山医院神经外科,上海200040

出　　处：《上海医药》2012年第23期7-9,共3页Shanghai Medical & Pharmaceutical Journal

摘　　要：目的:研究预防性应用抗生素在神经外科清洁手术中的作用。方法:回顾性地调查华山医院神经外科近3年内的住院病史3000余份,筛选出资料齐全的择期清洁开颅和椎管手术病史1510份,按预防性抗生素的不同用法分为A组(围手术期和术后均用抗生素)181例和B组(仅术后用抗生素)1329例,分析术后感染情况。结果:术后A、B两组的感染率分别为3.31%和4.36%(P>0.05)。术后出现脑脊液(CSF)漏的共有36例,这些病例的感染率为47.22%,其中A、B两组分别为33.3%和50.0%,与术后无CSF漏病例的感染率3.19%相比具有显著统计学差异(P<0.001)。结论:对围手术期和术后均预防性地应用抗生素是否是当前较理想的预防用药方案,应进行前瞻性的随机、对照研究以获取更准确的信息。Objective： To study the role of prophylactic use of antibiotics in neurosurgical clean operations. Methods： 1 510 cases of selective clean craniotomies and spinal cord operations were chosen from more than 3 000 patients＇ medical records in the department of neurosurgery for retrospective survey in Huashan hospital in recent three years. According to the different administrations of antibiotics for prophylaxis, these cases were divided into following two groups： Group A （183 cases）, the antibiotics were given perioperatively and postoperatively; Group B （1 329 cases）, the antibiotics were used only postoperatively. Results： Incidences of postoperative infection in Group A and Group B were 3.31% and 4.36% respectively （P〉0.05）. Infection occurred in 47.22% of 36 cases with postoperative cerebrospinal fluid （CSF） leakage, among which 33.3% of cases were in Group A and 50% were in Group B as compared with 3.19% in non-CSF-leakage cases. The difference had significance （P〈0.001）. Conclusion： Whether administration of antibiotics in both perioperative and postoperative periods is an ideal choice for prevention of neurosurgical postoperations infections, a prospective randomized control study should be conducted to obtain more accurate information.

关 键 词：预防性应用抗生素 神经外科 清洁手术 感染 

分 类 号：R619.3[医药卫生—外科学] R453.2[医药卫生—临床医学]