头颈部Ⅰ类手术切口感染与使用抗菌药物关系探讨  

Relationships between incision infections of head and neck typeⅠsurgery and use of antibiotics

作　　者：朱洪源[1] 施海丹[1] 李永连[1] 毛鑫礼[1] 

机构地区：[1]浙江省台州医院耳鼻咽喉头颈外科,浙江临海317000

出　　处：《中华医院感染学杂志》2014年第5期1124-1126,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生计划基金项目(2010KYA185)

摘　　要：目的了解头颈部Ⅰ类手术切口使用抗菌药物与切口感染的关系,为合理用药提供科学依据。方法回顾性分析2009年6月-2012年6月头颈部Ⅰ类手术切口的住院患者8 084例临床资料,调查其抗菌药物不同使用状态与切口部位感染的关系,感染率比较采用χ2检验,均数比较采用t检验,采用SPSS 13.0软件进行统计分析。结果连续3年抗菌药物使用率分别为40.92%、21.88%、8.58%,切口感染率分别为0.50%、0.50%、0.41%;统计手术时间<2h的头颈部Ⅰ类手术切口3年使用抗菌药物患者感染率0.13%,未使用抗菌药物患者感染率0.11%,使用抗菌药物与不使用抗菌药物切口感染率差异无统计学意义;送检切口部位标本检出的病原菌以革兰阳性菌为主,占71.4%,革兰阴性菌占28.6%。结论抗菌药物使用率与切口感染率无相关性,对于手术时间<2h的头颈部Ⅰ类清洁切口,抗菌药物的使用并不能降低切口感染发生。OBJECTIVE To observe the correlation between the use of antibiotics for head and neck type I surgery and the incision infections so as to provide scientific basis for reasonable use of antibiotics. METHODS Totally8084 hospitalized patients who underwent the head and neck type I surgery from Jun 2009 to Jun 2012 were retrospectively analyzed, then the relationship between the use of antibiotics and the incision infections was observed, the chi-square test was conducted for comparison of the infection rate, the t-test was carried out for comparison of the average number, and the statistical analysis was performed with the use of SPSS13. 0 software. RESULTS The utilization rates of antibiotics in the three consecutive years were 40. 92 %, 21. 88 %, and 8.58 % , respectively; the incidence rates of incision infections were 0. 50%, 0. 50%, and 0.41 %, respectively. The statistical analysis showed that among the patients with the operation duration less than 2 hours, the incidence of incision infections was 0. 13% in the patients who used antibiotics during the three years and was 0. 11% in the patients who did not use antibiotics, there was no statistical difference in the incidence of incision infections between the patients who used antibiotics and those who did not. Of the pathogens isolated from the submitted specimens from incision sites, the gram-positive bacteria accounted for 71. 4 % and the gram-negative bacteria accounted for 28. 6 %. CONCLUSION The utilization rate of antibiotics is not related to the incidence of incision infections. For the head and neck type I clean incision surgery with the duration less than 2 hours, the use of antibiotics can not reduce the incidence of incision infections.

关 键 词：I类手术切口 切口感染率 抗菌药物 合理性 

分 类 号：R978.1[医药卫生—药品]