低危腹腔镜腹股沟疝修补术使用预防性抗生素的前瞻性研究  

Prospective study on the use of prophylactic antibiotics in low-risk laparoscopic repair of groin hernia patients

作　　者：朱晓强[1] 刘正尼[1] 沈剑峰[1] 钟明安[1] 汤睿[1] 

机构地区：[1]上海市东方医院疝与腹壁外科,200120

出　　处：《中华疝和腹壁外科杂志（电子版）》2016年第6期410-413,共4页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的 探讨腹股沟疝患者行腹腔镜腹膜前腹股沟疝修补术是否需要使用预防性抗生素。方法 按照随机双盲法,前瞻性研究分析2015年5-12月,上海市东方医院200例腹腔镜下腹膜前腹股沟疝修补手术患者的临床资料,每组患者100例。非使用预防性生素组（试验组）术前30 min仅给予0.5%氯化钠溶液100 ml静脉滴注,而使用预防性抗生素组（对照组）术前30 min给予头孢唑林钠2 g＋0.5%氯化钠溶液100 ml静脉滴注。结果 术中1例TEP中转TAPP,1例TAPP中转开放,术后15例失访。最终入组183例,入组率91.5%,其中试验组89例（89%）,对照组94例（94%）。2组患者在手术部位感染、术后发热、血清肿和血肿的发生率上差异均无统计学意义（χ2=0.000、0.002、0.688、0.002,P=1.000、0.962、0.407、0.962）。结论 对于低危腹腔镜腹膜前腹股沟疝修补术,没有必要使用抗生素预防术后手术部位感染,不使用预防性抗生素也不会增加术后发热、血肿或血清肿的发生率。Objective The study was undertaken to discuss the role of prophylactic antibiotics in low-risk laparoscopic preperitoneal repair of groin hernia patients. Methods According to the randomized, double-blind design, a prospective study was carried out in the 200 cases of low-risk laparoscopic preperitoneal repair of groin hernia patients in department of hernia and abdominal wall surgery, Shanghai East Hospital between May 2015 and December 2015, and there were 100 patients in every group. The non- prophylactic antibiotics patients （test group ） were given 100 ml normal saline infusion 30 minutes before operation, while the prophylactic antibiotics patients （control group） were given cefazolin 2 g in 100 ml normal saline infusion. Results One case of TEP was transferred to TAPP and one case of TAPP was transferred to open surgery. These two patients were quitted from the study. Fifteen cases were lost to follow- up. Finally, 183 cases were enrolled in this study. The enrollment rate was 91.5%, 89 cases in the test group and 94 in the control group. Between the two groups, there were no significant differences in the incidence of surgical site infection, postoperative fever, seroma and hematoma. Conclusions It is unnecessary to use prophylactic antibiotics to prevent surgical site infection in low-risk （X^2 =0. 000,0. 002, 0. 688,0. 002, P = 1. 000,0. 962,0. 407,0. 962） laparoscopic preperitoneal repair of groin hernia patients. It does not increase the incidence of postoperative fever, serum and hematoma, without prophylactic antibiotics.

关 键 词：疝 腹股沟 疝修补术 感染 

分 类 号：R656.21[医药卫生—外科学]