骨科围手术期应用抗菌药物预防切口感染临床观察

目的 观察骨科患者围手术期规范应用抗菌药物预防切口感染的临床效果.方法 骨科手术患者580例随机分观察组及对照组各290例,观察组Ⅰ类手术术前30～60 min,用头孢替安,静脉滴注,手术时间＞3h追加一剂量；Ⅱ类手术术前、术中同Ⅰ类手术,术后静脉滴注头孢替安,1次/8h,共3次；对照组术前、术中未用药,术后应用头孢替安静脉滴注,2次/d,连续3～5 d.结果 观察组术后病率11.0％、退热时间(5.88±2.56)d、切口感染2.8％与对照组的12.1％、(5.65±2.67)d、3.5％比较差异无统计学意义；观察组术后住院时间(15.18±6.56)d,短于对照组的(19.89±7.13)d,差异有统计学意义(P＜0.05).结论 骨科患者术前应用单剂、术后短时问应用抗菌药物预防术后感染是一种有效、可行的模式,值得临床使用.

Clinical observation on application of antibiotics to prevent incision infections during perioperative period of orthopaedics surgery

OBJECTIVE To observe the clinical effect of standardized use of antibiotics to prevent incision infections during perioperative period.METHODS A total of 580 patients undergoing orthopaedic surgery were randomly divided into the observation group and the control group with 290 cases in each,the observation group was treated with cefotiam by intravenous drip at 30-60 min before typeⅠ surgery,with a dose added for the patients with operation duration more than 3h;before type Ⅱ surgery,typeⅠ intraoperative surgery,intravenous drip of cefotiam was performed for 3 times with 8h once;the control group did not use antibiotics before or during the surgery,intravenous drip of cefotiam was performed after the surgery,with twice a day for 3-5d.RESULTS The postoperative morbidity of the observation group was 11.0%,antifebrile time(5.88±2.56)d,incision infections;as compared with the control group 12.1%,(5.65±2.67)d,and 3.5%,the differences were not statistically significant;the postoperative hospitalization duration of the observation group was(15.18±6.56)d,shorter than(19.89±7.13)d,the difference was statistically significant.CONCLUSION The application of single-agent before operation and the use of antibiotics later after the operation o Orthopaedic patients is an effective and feasible pattern for the prevention of infections,which is worthy of the clinical application.