甲状腺切除术围手术期是否需要使用抗菌药物预防切口感染？  

Is prophylactic antibiotics necessary in prevention of incision infection after thyroidectomy？

作　　者：覃谦[1] 卢强[2] 李洪[1] 王力斌[1] 张万宇[2] 李爱辉[1] 陈思远[1] 欧阳杰[1] 梁卓虹[1] 谢书勤[1] 

机构地区：[1]中山大学附属东华医院肿瘤外科,广东省东莞523110 [2]中山大学附属东华医院普通外科,广东省东莞523110

出　　处：《中华普通外科杂志》2013年第8期597-600,共4页Chinese Journal of General Surgery

摘　　要：目的对不存在基础疾病、手术时间〈3h的甲状腺切除术患者围手术期是否需要使用抗菌药物预防手术部位感染（surgical site infection，SSI）进行探讨。方法2047例行甲状腺切除术患者分为未使用预防性抗菌药物组（no—prophylactic antibiotic therapy，nO-pABX）1030例，使用预防性抗菌药物组（prophylactic antibiotic therapy，pABX）1017例进行比较。结果两组手术时间分别为20～390min和30—320min，两组术后的SSI发生率均为0．1％；两组的手术时间和术后并发症比较差异无统计学意义（P〉0．05）。结论甲状腺切除术为清洁类切口，同时也具有手术时间短、出血少和术后并发SSI极低等特点。如术中严格遵守无菌原则和采用精细的操作技术，围手术期不预防性使用抗菌药物仍然是安全的。Objective To analyze whether prophylactic antibiotic administration is necessary forthe prevention of incision infection in patients undergoing thyroidectomy, a procedure that lasts less than 3 hours. Methods The clinical data of 2047 patients undergoing thyroidectomy were retrospectively analyzed. 1030 cases did not undergo prophylactic antibiotic therapy in perioperation. 1017 cases received prophylactic antibiotic therapy perioperatively. Results The operation time ranged from 20 min to 390 min in no-pABX group and that ranged from 30 min to 330 min in pABX group. Surgical site infection （SSI） developed respectively in 0. 1% in both the two groups. There were no significant differences in operation times and post-operative complications （ P 〉 0. 05 ）. Conclusions Classified as clear incision, SSI in thyroidectomy is rare, perioperative routine prophylactic antibiotic administration is unnecessary.

关 键 词：甲状腺切除术 抗生素预防 手术部位感染 

分 类 号：R653[医药卫生—外科学]