头孢西丁与他类抗菌药物在直肠癌患者手术部位术后感染中的效果及成本分析  

Effect of cefoxitin and other antimicrobial agents on prevention and treatment of postoperative surgical site infections in rectal cancer patients and cost analysis

作　　者：周高云[1] 吴开林[1] 林龙[1] 黎明[1] 林进维 赵国栋[2] 

机构地区：[1]海南省中医院普外科,海南海口570100 [2]海口市人民医院胃肠外科,海南海口570100

出　　处：《中华医院感染学杂志》2017年第24期5630-5633,5691,共5页Chinese Journal of Nosocomiology

摘　　要：目的研究头孢西丁与他类抗菌药物在直肠癌患者术后手术部位感染中的运用效果及成本效果分析。方法选取2012年6月-2016年5月医院直肠癌手术患者124例,根据用药不同,将纳入的124例直肠癌手术患者分为A组、B组、C组、D组,每组各31例,A组给予注射用头孢西丁钠、B组给予注射用头孢唑林钠、C组给予注射用头孢美唑钠、D组给予注射用头孢他啶,比较四组患者术后发热率、手术部位感染率、愈合率、药物不良事件、治疗成本(直接成本、间接成本、隐形成本)、效价。结果 A组治疗总有效率为100.00%,高于B组的93.55%、C组的96.77%和D组的93.55%,但差异无统计学意义;A组、B组、C组和D组术后发热率、手术部位感染率比较差异无统计学意义;A组成本-效果比低于B组、C组和D组(P<0.05)。结论头孢西丁相对其他类抗菌药物而言,在直肠癌手术部位感染中应用效果较好且经济实惠,是一种具有最小成本效果比值的优选方案,更具经济学价值,符合当前医保控费政策,有助于有限药物资源合理配置,降低患者经济负担、提高社会效益。OBJECTIVE To observe the effect of cefoxitin and other antimicrobial agents on prevention and treatment of postoperative surgical site infections in rectal cancer patients and conduct cost-effectiveness analysis.METHODS A total of 124 rectal cancer patients who received surgical procedures from Jun 2012 to May 2016 were enrolled in the study and divided into the group A,B,C,and D according to the use of antibiotics,with 31 cases in each group.The group A was treated with cefoxitin sodium injection,the group B was treated with cefazolin sodium injection,the group C was treated with cefmetazole injections,and the group D was treated with ceftazidime injection.The incidence of postoperative fever,incidence of surgical site infection,cure rate,drug-induced adverse events,treatment cost（direct cost,indirect cost,implicit cost）and potency were observed and compared among the four groups of patients.RESULTS The total effective rate of treatment of the group A was 100.00%,higher than 93.55% of the group B,96.77% of the group C and 93.55% of the group B,however,there was no significant difference.There was no significant difference in the incidence of postoperative fever or incidence of surgical site infections among the group A,B,C and D.The cost-effectiveness ratio of the group A was lower than that of the group B,C and D（P 〈0.05）.CONCLUSION As compared with other antimicrobial agents,cefoxitin,which has the minimum cost-effectiveness ratio,is economical and practical and can achieve remarkable effect on prevention and treatment of surgical site infections in the rectal cancer patients,it is more economically valuable and conforms to the current medical insurance policy,contributes to the rational allocation of limited drug resources,reduces the economic burden of patients and improves social benefits.

关 键 词：直肠癌 手术 感染 头孢西丁 效价 

分 类 号：R619.3[医药卫生—外科学]