抗生素使用时间与预防肝切除术后手术部位感染效果的相关性分析  

The effectiveness of prolonged antibiotic use in preventing surgical site infections after hepatectomy

作　　者：白振华 施祥德 唐启彬[1] 余先焕[1] 张锐[1] 刘超[1] Bai Zhenhua;Shi Xiangde;Tang Qibin;Yu Xianhuan;Zhang Rui;Liu Chao(Department of Biliary and Pancreatic Surgery,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510288,China)

机构地区：[1]中山大学孙逸仙纪念医院胆胰外科,广州510288

出　　处：《中华普通外科杂志》2024年第7期534-538,共5页Chinese Journal of General Surgery

基　　金：中山大学临床医学研究5010计划资助项目(2018008);广东省基础与应用基础研究基金项目(2019A1515110037,2020A1515010181)。

摘　　要：目的分析抗生素预防肝切除术后手术部位感染(surgical site infection,SSI)的有效性。方法回顾性分析2019年1月至2021年12月于中山大学孙逸仙纪念医院施行肝切除术患者的临床资料。结果共509例患者纳入研究。不同预防治疗时间组的SSI发生率差异无统计学意义(P>0.05)。单因素分析结果显示胆漏、肝切除范围、手术方式、麻醉分级和手术时间为影响肝切除术后SSI的可能危险因素(P<0.05);多因素分析结果显示胆漏、大范围肝切除、开放性手术方式、3~4级麻醉级别和手术时间>300 min可能是影响肝切除术后SSI的独立危险因素(P<0.05)。结论肝切除术后延长抗生素使用时间以预防手术部位的感染可能是不必要的。ObjectiveTo investigate the effectiveness of antibiotics in preventing surgical site infection(SSI)after hepatectomy.MethodsThe clinical data of patients who underwent hepatic resection at the Department of Biliary and Pancreatic Surgery,Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,from Jan 2019 to Dec 2021,were retrospectively analyzed.ResultsA total of 509 patients were included in the study.There was no statistically significant difference in the incidence of SSI in the different prophylactic treatment time groups(P>0.05).Univariate analysis revealed bile leakage,extent of hepatic resection,surgical procedure,level of anesthesia,and duration of surgery as potential risk factors for SSI after hepatic resection(P<0.05);Multivariate analysis showed that bile leakage,extensive hepatic resection,open surgical approach,grade 3-4 anesthesia level,and operative time longer than 300 minutes might be independent risk factors affecting SSI after hepatectomy(P<0.05).ConclusionProlonging antibiotic prophylaxis for SSI after hepatectomy may be unnecessary.

关 键 词：肝切除术 手术部位感染 抗生素 危险因素 

分 类 号：R657.3[医药卫生—外科学]