慢性鼻窦炎术后合理使用抗生素的研究  

Reserch on rational use of antibiotics after operation of chronic sinusitis

作　　者：张杰[1] 陈静[1] 黄立高 胡秀娟[1] 洪逸光[1] 康伟 刘栖如[1] ZHANG Jie;CHEN Jing;HUANG Li-gao;HU Xiu-juan;HONG Yi-guang;KANG Wei;LIU Xi-ru(Department of Otolaryngology,the Affiliated Hospital of Chengdu University,Sichuan Province,Chengdu 610081,China;Department of Inpatient,Ren-Pin Otolaryngology Hospital of Chengdu,Sichuan Province,Chengdu 610072,China)

机构地区：[1]成都大学附属医院耳鼻咽喉科,四川成都610081 [2]成都仁品耳鼻喉专科医院住院部,四川成都610072

出　　处：《中国当代医药》2019年第20期102-105,共4页China Modern Medicine

基　　金：四川省医学会科研课题计划(S15007)

摘　　要：目的探讨慢性鼻窦炎术后炎症指标变化的特点,指导术后合理使用抗生素,为慢性鼻窦炎的规范化治疗提供参考依据。方法选取2016年1月~2018年1月成都大学附属医院耳鼻喉科和成都仁品耳鼻喉专科医院住院部收治的244例慢性鼻窦炎患者作为研究对象,随机分为非抗生素使用组(A组)、标准抗生素使用组(B组)及延长抗生素使用组(C组)。A组在术前、术后均不给予抗生素,B组48h以内使用抗生素,C组使用抗生素时间>48h直至出院。三组术后第1天查血常规,术后第1、3天查C反应蛋白(CRP),观察患者是否感染。结果三组患者术后第1天的白细胞阳性率比较,差异无统计学意义(P=0.202)。三组患者术后第1、3天的CRP阳性率比较,差异无统计学意义(P=0.814、0.219)。三组患者术后的感染率分别为3.5%、2.7%、0.0%,差异无统计学意义(P=0.243)。结论慢性鼻窦炎术后白细胞、CRP常升高,但是感染率极低。预防性使用抗生素并不能降低上述炎症指标的阳性率,不推荐常规使用抗生素预防感染。Objective To explore the characteristics of inflammation index changes after operation of chronic sinusitis,and to guide rational use of antibiotics after operation so as to provide reference for the standardized treatment of chronic sinusitis.Methods Altogether 244 patients with chronic sinusitis who were treated from January 2016 to January 2018 in Department of Otolaryngology of the Affiliated Hospital of Chengdu University and Department of Inpatient of Ren-Pin Otolaryngology Hospital of Chengdu were selected as the research objects.They were randomly divided into the non-antibiotic use group (group A),the standard antibiotic use group (group B) and the prolonged antibiotic use group (group C).Group A was not given antibiotics before and after operation,group B was given antibiotics within 48 hours,group C was given antibiotics for more than 48 hours until discharge.The blood routine was checked on the first day after operation in the three groups,and C-reactive protein (CRP) was checked on the first and third days after operation to observe whether the patients were infected.Results On the first day after operation,there were no significant differences in the positive rate of leukocyte among the three groups (P=0.202).On the first and third day after operation,there were no significant differences in the positive rate of CRP among the three groups (P=0.814,0.219).Postoperative infection rates of the three groups were 3.5%,2.7% and 0.0%,respectively,without statistical difference(P=0.243).Conclusion Leukocyte and CRP often increase after operation of chronic sinusitis,but the infection rate is very low.Preventive use of antibiotics can not reduce the positive rate of appellate inflammation indicators.It is not recommended to use antibiotics routinely to prevent infection.

关 键 词：慢性鼻窦炎 鼻腔手术 抗生素 感染 

分 类 号：R765.41[医药卫生—耳鼻咽喉科]