介入手术抗菌药物应用的回顾性调查  

Reasonable and preventive use of the antibiotics after interventional procedure: a retrospective investigation

作　　者：鲁海涛[1] 王珏[1] 张培蕾[1] 程永德[1] 

机构地区：[1]上海交通大学附属第六人民医院介入影像科,200233

出　　处：《介入放射学杂志》2013年第2期141-143,共3页Journal of Interventional Radiology

摘　　要：目的 通过对不同时期介入手术围手术期预防性抗菌药物应用的调查，以加强围手术期抗菌药物合理应用的管理。方法 采用回顾性调查方法，对2007年1月—2011年12月共有3 546例出院患者围手术期预防性抗菌药物应用的资料进行统计分析。根据患者预防性应用抗生素的情况分为两组。A 组：介入手术常规应用抗生素，即术后静脉滴注第二代头孢菌素类抗生素或克林霉素2 ~ 3 d，其中血管内手术1 362例，非血管内手术1 146例，本组患者共2 508例。B组：一般情况术后不应用抗生素，其中血管内手术680例，非血管内手术358例，本组患者共1 038例。结果 A、B两组术后感染率分别为0.44%和0.39%，其中血管内手术术后感染率分别为0.29%和0.15%，非血管内手术术后感染率分别为0.61%和0.84%，两组间差异无统计学意义（P ＞ 0.05）。而且两组间平均住院天数差异无统计学意义（P ＞ 0.05）。结论 一般状况良好的择期介入手术患者常规情况下不需预防性应用抗生素。Objective To strengthen the management of the rational use of antibiotics after interventional procedure through a full-scale retrospective investigation about the perioperative preventive use of antibiotics in different periods. Methods By using retrospective investigation method, the clinical data about the perioperative use of antibiotics in 3 546 patients, who were treated with interventional management during the period from Jan. 2007 to Dec. 2011 in authors＇ hospital, were statistically analyzed. Based on the way of preventive use of antibiotics, the patients were divided into two groups. Patients in group A （n = 2 508） routinely received antibiotics, i.e. intravenous dropping of secondgeneration cephalosporins or clindamycin antibiotics for 2 N 3 days after interventional management, including endovascular procedure （n = 1 362） and non-vascular procedure （n = 1 146）. Patients in group A （n = 1 038） did not receive any antibiotic after the interventional management, including endovascular procedure （n = 680） and non-vascular procedure （n = 358）. The results were analyzed and compared between the two groups. Results The infection rates of group A and group B were 0.44% and 0.39% respectively. The infection rates after endovascular procedure in group A and group B were 0.29% and 0.15% respectively, while the infection rates after nonvascular procedure in group A and group B were 0.61% and 0.84% respectively. The differences in postoperative infection rate between the two groups were not statistically significant （P 〉 0.05）. No statistically significant difference in the mean hospitalization days existed between the two groups （P 〉 0.05）. Conclusion For patients in good general condition, it is not necessary to preventively use antibiotics after a time-selective interventional procedure.

关 键 词：介入 预防 抗生素 

分 类 号：R619[医药卫生—外科学]