围手术期抗生素使用策略在预防肩袖术后感染中的有效性分析  

Effectiveness Analysis of Perioperative Antibiotic Use Strategy in Preventing Infection After Rotator Cuff Surgery

作　　者：杨洋 黄俊淇 唐诗添[2] Yang Yang;Huang Junqi;Tang Shitian(Department of Orthopaedics,Yubei District People′s Hospital,Chongqing 401120;Department of Orthopaedics,Mianyang Central Hospital,Mianyang,Sichuan 621000,China)

机构地区：[1]渝北区人民医院骨一科,重庆401120 [2]绵阳市中心医院骨科,四川绵阳621000

出　　处：《四川医学》2023年第1期46-50,共5页Sichuan Medical Journal

摘　　要：目的 探讨围手术期抗生素的使用策略对预防肩袖术后感染的有效性及其临床意义。方法 回顾性分析2019年7月1日至2021年10月1日我院肩关节镜下行肩袖撕裂修复术的患者临床资料。对比不同抗生素使用策略在不同年龄组(A组>60岁、B组<60岁)患者术后下床活动时间、住院天数、白细胞计数(WBC)、血沉(ESR)、C-反应蛋白(CRP)、白介素-6(IL-6)、 Constant-Murley肩关节评分、 UCLA肩关节评分和术后感染率。结果 共纳入180例患者,A、B两组患者在性别、年龄、手术时间、吸烟与否方面差异无统计学差异(P>0.05),两组患者组内比较下床活动时间以及住院天数、术前术后相应时间点WBC、ESR、CRP、IL-6水平组内比较差异均无统计学意义(P>0.05)。Constant评分和UCLA肩关节评分系统手术前后相应时间点组内比较差异无统计学意义(P>0.05),所有患者的肩关节功能评分术后都较术前有明显改善,差异有统计学意义(P<0.05)。A组1例术后感染,两组感染率比较,差异有统计学意义(P<0.05)。结论 年龄并不是肩袖术后感染的独立危险因素,高龄合并控制不佳的慢性病患者在行肩关节镜手术时建议术前预防性使用1组抗生素。而对于手术时间<90 min的患者行肩关节镜下肩袖损伤修复的患者中不建议预防性抗生素的使用。Objective To investigate the effectiveness and clinical significance of perioperative use of antibiotics in preventing infection after rotator cuff surgery.Methods Clinical data of patients undergoing rotator cuff tear repair under arthroscopy of shoulder joint in our hospital from July 01,2019 to October 01,2021 were retrospectively analyzed.The time to get out of bed, days of hospitalization, white blood cell count(WBC),erythrocyte sedimentation rate(ESR),c-reactive protein(CRP),interleukin-6(IL-6),Constant-Murley shoulder joint score, UCLA shoulder joint score and postoperative infection rate of patients in different age groups(Group A>60 years old and Group B<60 years old)with different antibiotic use strategies after surgery were investigated.Results A total of 180 standard cases were included in the study.No significant difference was found in gender, age, operation time, and smoking status between Group A and B(P>0.05).There was no significant difference in the time of patients getting out of bed and the number of hospital days, the white blood cell count, erythrocyte sedimentation rate, CRP and IL-6 levels in the corresponding time points before and after operation in each group(P>0.05).There was no significant difference in Constant score and UCLA shoulder joint score at the corresponding time points before and after operation between the two groups(P>0.05).The shoulder joint function scores of all the patients after operation were significantly improved as compared with those before operation, and the difference was statistically significant(P<0.05).In the comparison of postoperative infection situations between group A and group B,one infected patient was found in group A.The difference was considered to be statistically significant in the comparison of infection rates between the two groups(P<0.05).Conclusion Age is not an independent risk factor for postoperative rotator cuff infection, and preoperative prophylactic administration of one group of antibiotics is recommended in patients with advanced a

关 键 词：肩袖损伤 肩袖修复术 肩关节镜术 感染 预防性抗生素 

分 类 号：R681.53[医药卫生—骨科学]