内镜下黏膜剥离术围手术期预防用抗菌药物的临床调查  

Clinical investigation of prophylactical use of antibacterials in perioperative period of endoscopic submucosal dissection

作　　者：胡娟妮 朱冠华[1] 程学芳[1] HU Juan-ni;ZHU Guan-hua;CHENG Xue-fang(Department of Clinical Pharmacy,Shanghai General Hospital Affiliated to Shanghai Jiao Tong University,Shanghai 200080)

机构地区：[1]上海交通大学附属第一人民医院临床药学科

出　　处：《中南药学》2019年第11期1991-1994,共4页Central South Pharmacy

摘　　要：目的探讨围手术期应用抗菌药物对内镜下黏膜剥离术(ESD)术后感染的预防价值。方法回顾性分析2018年5月至2019年2月在该院消化内镜中心行ESD术治疗的272例患者资料。根据临床药师干预前后的围手术期抗菌药物应用情况,将收集的病例资料分为未规范使用抗菌药物组(A组)和规范使用抗菌药物组(B组)。观察两组术后感染情况,比较A、B两组感染发生率。并采用Logistic回归分析感染的危险因素。结果A组和B组临床基本情况无显著性差异。两组术后感染发生率比较,差异无统计学意义(P>0.05);多因素Logistic回归结果示:有吸烟史患者、年龄大于60岁患者,术后感染发生率更高(P<0.05)。结论ESD围手术期使用三代头孢菌素或喹诺酮类抗菌药物,不能降低ESD术后感染发生率。Objective To determine the preventive use of antibiotics against postoperative infection in perioperative period of endoscopic submucosal dissection(ESD).Methods We retrospectively analyzed the clinical data of 272 patients with ESD in the Digestive Endoscopy Center of our hospital from May 2018 to Feb.2019.According to the application of antibiotics in the perioperative period before and after the intervention by clinical pharmacists,the collected data were divided into an unstandardized antibiotic group(group A)and a standardized antibiotic group(group B).Then the postoperative infection was observed and compared in the two groups.Logistic regression analysis identified the risk factors for the infection.Results There was no significant difference in the clinical status between group A and group B,and no significant difference in the incidence of postoperative infection(P>0.05).The incidence of postoperative infection was higher in patients with smoking history and among 60 years old and above(P<0.05).Conclusion The use of third-generation cephalosporin or quinolone antibiotics during perioperative period of ESD fails to reduce the incidence of postESD infection.

关 键 词：内镜下黏膜剥离术 预防性抗菌药物 头孢菌素 喹诺酮类 

分 类 号：R95[医药卫生—药学]