围手术期抗菌药物用药时间对老年腹腔镜胆囊切除患者术后感染的影响  

Efficacy of different antimicrobial drug using time for preventing surgical site infection(SSI) following laparoscopic cholecystectomy in elderly patients

作　　者：夏红霞[1] 廖晓锋[1] 王玲[1] 王芳[1] 

机构地区：[1]襄阳市中心医院湖北文理学院附属医院普外科,湖北襄阳441021

出　　处：《临床药物治疗杂志》2018年第1期65-68,共4页Clinical Medication Journal

基　　金：襄阳市科学技术局基金项目(襄医[2013]7号)

摘　　要：目的:研究老年患者腹腔镜胆囊切除术围手术期抗菌药物用药疗程对术后感染率的影响。方法:237例腹腔镜胆囊切除术患者随机分为A组、B组和C组,每组79例。A组术前静脉滴注头孢呋辛1.5g;B组术前静脉滴注头孢呋辛1.5 g,术后持续用药24 h;C组术前静脉滴注头孢呋辛1.5 g,术后持续用药72 h。观察3组患者术后感染率、体温恢复正常时间、血像恢复正常时间、降钙素原(PCT)恢复正常时间、术后平均住院时间和平均抗菌药物费用。结果:A组、B组和C组的术后感染率分别为16.46%、3.80%和2.53%,A组与B组和C组均存在显著性差异(P<0.05),B组和C组无显著性差异(P>0.05);A组患者体温恢复正常时间、血像恢复正常时间、PCT恢复正常时间和术后平均住院时间均显著大于B组和A组,差异均具有统计学意义(P<0.05);B组和C组比较无显著性差异(P>0.05);A组、B组和C组抗菌药物费用分别为(178.7±54.7)、(117.6±27.4)和(131.3±31.8)元,三组抗菌药物费用均存在显著性差异(P<0.01)。结论:老年患者腹腔镜胆囊切除术,术前静脉滴注头孢呋辛1.5 g,术后继续使用24 h能有效预防术后感染,且抗菌药物费用最小。Objective： To evaluate the efficacy of different antimicrobial drug using time for preventing surgical site infection（SSI） following laparoscopic cholecystectomy in elderly patients. Methods： 237 patients with laparoscopic cholecystectomy were randomly divided into group A, group B and group C with 79 patients in each group. Patients in group A were intravenously given 1.5 g cefuroxime before operation. Patients in group B were intravenously given 1.5 g cefuroxime before operation, and continued using for 24 hours after operation. Patients in group C were intravenously given 1.5 g cefuroxime before operation, and continued using for 72 hours after operation. Postoperative infection rate, time of body temperature recovery, time of routine blood test recovery, time of procalcitonin（PCT） recovery, average hospitalization time after operation and average antimicrobial cost were observed in three groups. Results： Postoperative infection rates of group A, group B and group C were 16.46%, 3.80% and 2.53% respectively with significant differences between group A and group B and between group B and group C（P0.05）, and no significant difference between group B and group C（P0.05）. Time of body temperature recovery, time of routine blood test recovery, time of PCT recovery in group A were significantly less than those of group B and group C（P0.05） without significant difference between group B and group C（P0.05）. Average antimicrobial cost of group A, group B and group C were（178.7±54.7） yuan,（117.6±27.4） yuan and（131.3±31.8） yuan respectively with significant difference among three groups（P0.01）. Conclusion： Preoperative prophylactic use of 1.5 g cefuroxime and postoperative continued medication for 24 hours can prevent SSI effectively for elderly patients undergoing elective laparoscopic cholecystectomy, and meanwhile the antimicrobial cost is minimal.

关 键 词：胆囊切除术 腹腔镜 围手术期 用药时间 术后感染率 

分 类 号：R978.1[医药卫生—药品]