老年患者腹股沟疝补片修补术预防性使用抗菌药物临床研究  

Clinical study on prophylactic use of antibiotics in repair of inguinal hernia in elderly patients

作　　者：卓烨烨[1] 李欣欣[2] 陈君填[2] 蔡德[1] ZHUO Yeye;LI Xinxin;CHEN Juntian;CAI De(Department of Pharmacy,FirstAffiliated Hospital of Shantou UniversityMedical College,Shantou 515041,China;Department of Gastrointestinal Surgery,FirstAffiliated Hospital of Shantou UniversityMedical College,Shantou 515041,China)

机构地区：[1]汕头大学医学院第一附属医院药剂科,广东汕头515041 [2]汕头大学医学院第一附属医院胃肠外科,广东汕头515041

出　　处：《汕头大学医学院学报》2020年第1期5-9,共5页Journal of Shantou University Medical College

基　　金：广东省医学科学技术研究基金(A2018447)。

摘　　要：目的:探讨老年低危患者择期腹股沟疝补片修补术前预防性使用抗菌药物的必要性。方法:回顾性分析2014年1月至2018年5月在汕头大学医学院第一附属医院行腹股沟疝补片修补术(开放性腹股沟疝无张力修补术和腹腔镜腹股沟疝修补术)的老年低危患者的临床资料,对手术部位感染(SSI)进行1年的观察随访。采用单因素和多因素Logistic回归分析SSI发生的危险因素。结果:最终纳入679例患者(开放性手术422例,腹腔镜手术257例)。其中211例术前一次性应用预防性抗菌药物,468例未予抗菌药物预防。随访1年后,开放性手术后总SSI发生率为7.34%(31/422),多因素Logistic回归分析显示预防性使用抗菌药物有助于降低SSI的风险(OR=0.065,P=0.008)。腹腔镜手术后总SSI发生率3.11%(8/257),预防性使用抗菌药物对SSI无显著性影响(P=0.995)。结论:老年低危患者行开放性腹股沟疝无张力修补术前预防性使用抗菌药物能有效降低术后SSI,但对于腹腔镜腹股沟疝修补术,抗菌药物预防无必要性。Objective:To explore the necessity of prophylactic use of antibiotics before the repair of inguinal hernia patch in elderly patients with low risk.Methods:The clinical data of low-risk elderly patients who underwent inguinal hernia patch repair(open inguinal hernia tension-free repair and laparoscopic inguinal hernia repair)in the First Affiliated Hospital of Shantou University Medical College from January 2014 to May 2018 were analyzed retrospectively.The surgical site infection(SSI)was observed and followed up for one year.Single factor and multi factor logistic regression were used to analyze the risk factors of SSI.Results:679 patients(422 open surgery and 257 laparoscopic surgery)were included.Among them,211 cases were treated with prophylactic antibiotics before operation,and 468 cases were not treated with prophylactic antibiotics.After 1 year follow-up,the total incidence of SSI after open surgery was 7.34%(31/422).Multivariate logistic regression analysis showed that prophylactic use of antibiotics could reduce the risk of SSI(OR=0.065,P=0.008).The total incidence of SSI after laparoscopic surgery was 3.11%(8/257).Prophylactic use of antibiotics had no significant effect on SSI(P=0.995).Conclusion:Prophylactic use of antibiotics before tension-free inguinal hernia repair can effectively reduce SSI,but for laparoscopic inguinal hernia repair,the prevention of antibiotics is not necessary.

关 键 词：手术部位感染 腹股沟疝补片修补术 抗菌药物 老年低危患者 

分 类 号：R619.3[医药卫生—外科学]