普外科患者术后抗菌药物应用对切口感染的影响研究  

Effect of using antibiotics to incision infection in department of general surgery patients after operation

作　　者：彭俊华[1] 郑晓华[2] 李群英[1] 赵旋[1] 杨胜芬 李辉蓉[1] 曾鹏飞[1] 

机构地区：[1]遵义市第一人民医院手术室,贵州遵义563000 [2]遵义医学院肝胆胰脾外科,贵州遵义563000

出　　处：《中华医院感染学杂志》2016年第20期4664-4666,共3页Chinese Journal of Nosocomiology

基　　金：贵州省科技厅科学技术基金资助项目[黔科合J(2013)2311]

摘　　要：目的探讨普外科患者术后抗菌药物应用种类、时机、方案对术后切口感染发生的影响,以期为普外科患者术后抗菌药物合理应用提供指导依据。方法回顾性分析医院2014年1月-2015年12月300例普外科手术治疗患者临床资料,随抗菌药物应用时机分为A、B、C 3组,A组86例为术前1~2h开始应用抗菌药物,B组112例为术前0.5~1h开始应用抗菌药物,C组102例为术中或术后开始应用抗菌药物,观察3组患者术后切口感染发生率。结果 3组患者抗菌药物应用主要以头孢菌素类为主,其次为青霉素类、喹诺酮类、硝基咪唑类,均以联合抗菌药物预防为主,A组占84.88%,B组占81.25%,C组占79.41%,三组抗菌药物应用方式对比,差异无统计学意义;A组患者术后发生切口感染率为5.81%,B组为6.25%,C组为14.71%,3组患者切口感染率对比,差异有统计学意义（P〈0.05）;术后1d停用抗菌药物,发生切口感染17例,术后2d停用抗菌药物发生切口感染10例,术后3d、5d停药均发生1例,3组不同时间停药术后切口感染率对比,差异有统计学意义（χ2=25.548,P〈0.05）;单一应用抗菌药物,术后1d与术后2d患者发生切口感染率对比,差异无统计学意义,与术后3、5d患者发生切口感染率对比,差异有统计学意义（χ2=7.501,P〈0.05）;联合应用抗菌药物,术后1d与术后2d患者切口感染率对比,差异无统计学意义,与术后3、5d患者切口感染率对比,差异有统计学意义（χ2=5.042,P〈0.05）。结论普外科手术患者抗菌药物应用,应在《抗菌药物临床应用指导原则》基础上给予个性化运用,同时关注最新及当地切口感染病原学分析、药敏试验,以降低普外科患者术后切口感染率。OBJECTIVE To investigate the effects of different types, timing and scheme of antibiotics on the postop- erative wound infection in department of general surgery patients, in order to provide guidance for rational use of antibiotics in department of general surgery. METHODS A total of 300 cases of clinical data of patients in general surgery by operation treatment in our hospital from Jan. 2014 to Dec. 2015 were retrospectively analyzed, who were divided into three groups A, B, C according to antibacterial drugs application time, group A with 86 cases, using antibacterial drugs preoperative 1 ~ 2H, group B with 112 cases, using antibacterial drugs preoperative OH, and group C with 102 cases, using antimicrobial agents during or after operation. The incidence of incision in- fection in three groups were observed after operation. RESULTS Cephalosporins were the main antimicrobial a- gents in these three groups, followed by penicillins, quinolones and nitroimidazoles, which were all using the way of drug combination, accounting for 84.88% in group A, 81.25% in group B and 79.41% in group C, and there were no significant difference in three groups of antimicrobial drug use. The incision infection rate in group A was 5.81%, group B 6.25%, group C 14.71%, and there was significant difference in these three groups（P〈0.05）. There were 17 cases of incision infection stop using antimicrohial drugs 1D after operation, 10 cases 2D after oper- ation, 1 case 3D or 5D after operation, and the difference was significant in three groups （X2 = 25. 548, P〈0.05）. The incidence of incision infection rates 1D and 2D after operation with single application of antibacteri- al drugs had no significant difference, but higher than that after aD, 5D of operation with significant difference （X^2=7. 501 ,P〈0.05）. The incidence of incision infection rates 1D and 2D after operation with drug combination therapy had no significant difference, but higher than that after aD, 5D of operation with significant difference （X^2 = 5.

关 键 词：手术 切口感染 抗菌药物应用时机 药物种类 

分 类 号：R978.1[医药卫生—药品]