骨科Ⅰ类切口手术抗菌药物应用方案的研究  

Study on application of antibiotics for orthopedic class Ⅰ incision surgery

作　　者：李晨[1] 李兴艳[1] 田林强[1] 郭风劲[1] 陈安民[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院骨科,湖北武汉430030

出　　处：《中华医院感染学杂志》2012年第23期5361-5363,共3页Chinese Journal of Nosocomiology

摘　　要：目的研究骨科Ⅰ类切口手术抗菌药物应用方案,提供科学使用依据。方法收集骨科Ⅰ类切口手术患者资料,将抗菌药物使用方案分类:方案1按《抗菌药物临床应用指导原则》使用,方案2为未达到方案1标准但术后使用≤3d,方案3为抗菌药物术后使用≥4d;分析不同方案与术后感染的关系及相关影响因素。结果方案1～3术后切口感染率分别为5.23%、5.65%、1.21%;脊柱类疾病中,方案1感染率为6.06%,高于方案3的0;术后抗菌药物使用0、1d感染率分别为5.39%、6.76%,均高于方案3的1.21%;logistic回归分析提示关节成形与关节疾病、手、显微外科疾病比脊柱类疾病术后感染风险低。结论脊柱类疾病Ⅰ类切口手术术后抗菌药物使用2d能有效预防切口感染,其他骨科手术抗菌药物使用应参照《抗菌药物临床应用指导原则》。OBJECTIVE To analyze the application of antibiotics for orthopedic class Ⅰ incision surgery so as to provide bases for scientific application. METHODS The clinical data of the patients who underwent orthopedic class Ⅰ incision surgery were collected, the use of antibiotics was divided into three categories, type 1 was based on national standard. Type 2 was not strict with the national standard, but the postoperative use of antibiotics was less than three days, type 3 was the control group with the postoperative use of antibiotics more than 4 days; the correlation between the application programs and the postoperative infections as well as the impact factors was analyzed. RESULTS The postoperative incision infection rates of the three application programs were 5. 23%, 5.65%, 1.21% respectively; in the spine diseases, the infection rate of the type 1 was 6.06%, higher than 0% of the type 3% the infection rates of using antibiotics within 0% and one day were 5.39% and 6.76%, both higher than 1.12 % of type 3 ; logistic regression analysis indicated that the risk of the infeetions in the patients with joint diseases, hand-foot diseases or microscope surgery diseases was significantly decreased as cotnpared with the patients with spine diseases. CONCLUSION The application of antibiotics for postoperative class Ⅰ incision surgery for 2 clays can effectively prevent incision infections, and the application of antibiotics for other orthopedic surgeries should be performed by referring guidelines for clinical use of antibiotics.

关 键 词：外科手术部位感染 Ⅰ类切口手术 抗菌药物 

分 类 号：R978.1[医药卫生—药品]