预防性应用抗生素对急性结石性胆囊炎腹腔镜胆囊切除术伤口感染的影响  

Effect of Prophylactic Antibiotic on Wound Infection in Laparoscopic Cholecystectomy for Acute Calculous Cholecystitis

作　　者：权其仁 QUAN Qiren(Yongfeng County People's Hospital,Ji'an Jiangxi 331500,China)

机构地区：[1]永丰县人民医院,江西吉安331500

出　　处：《药品评价》2023年第12期1549-1552,共4页Drug Evaluation

摘　　要：目的探讨预防性应用抗生素对急性结石性胆囊炎腹腔镜胆囊切除术伤口感染的影响。方法选取76例2020年1月至2022年12月在永丰县人民医院接受腹腔镜胆囊切除术治疗的急性结石性胆囊炎患者,按数字随机表法分作两组,对照组38例围术期不使用抗生素,观察组38例于围术期预防性予以抗生素。对比两组炎性因子水平、切口感染及其他感染发生情况、术后疼痛与恢复情况。结果两组术后24 h、48 h时的超敏C反应蛋白(hs-CRP)、白细胞(WBC)计数水平比较差异无统计学意义(P>0.05);观察组切口感染发生率是2.63%,与对照组的5.26%比较差异无统计学意义(P>0.05),且观察组其他感染发生率是5.26%,与对照组的7.89%比较差异无统计学意义(P>0.05);两组术后12 h与48 h的视觉模拟评分法(VAS)评分、术后肛门排气、首次肛门排便、首次进食及住院的时间比较差异无统计学意义(P>0.05);术后7 d时,两组40项术后恢复质量调查问卷(QoR-40)评分对比较差异无统计学意义(P>0.05)。结论急性结石性胆囊炎接受腹腔镜胆囊切除术治疗时,预防性使用抗生素并不会降低术后切口感染发生率,对患者术后疼痛、恢复情况也无明显影响。Objective To investigate the effect of prophylactic antibiotics on wound infection in laparoscopic cholecystectomy for acute calculous cholecystitis.Methods 76 cases of patients with acute calculous cholecystitis who were received laparoscopic cholecystectomy in Yongfeng County People's Hospital from January 2020 to December 2022 were selected,they were divided into two groups according to the random table method.38 cases in the control group were not treated with antibiotics during perioperative period,while 38 cases in the observation group were treated with prophylactic antibiotics during perioperative period.The levels of inflammatory factors,the incidence of incision infection and other infections,postoperative pain and recovery were compared between the two groups.Results There was no significant difference in the counting levels of hypersensitive C-reactive protein(hs-CRP)and white blood cell(WBC)between the two groups at 24 h and 48 h after surgery(P>0.05).The incidence of incision infection in the observation group was 2.63%,with no statistical significance compared with 5.26%in the control group(P>0.05),and the incidence of other infections in the observation group was 5.26%,with no statistical significance compared with 7.89%in the control group(P>0.05).Visual analog scale(VAS)scores at 12 h and 48 h after surgery,postoperative anal exhaust,first anal defecation,first eating and hospitalization time were not statistically significant between the two groups(P>0.05).At 7 days after surgery,there was no significant difference between the two groups in 40 items of postoperative recovery quality questionnaire(QoR-40)scores(P>0.05).Conclusion Prophylactic antibiotic use does not reduce the incidence of postoperative incision infection in patients undergoing laparoscopic cholecystectomy for acute calculous cholecystitis,and has no significant effect on postoperative pain and recovery.

关 键 词：抗生素预防 急性结石性胆囊炎 腹腔镜胆囊切除术 伤口感染 

分 类 号：R657.4[医药卫生—外科学]