3367例清洁伤口术预防性应用抗生素的调查

目的：了解清洁伤口术预防性使用抗生素的情况，评价其使用的合理性，方法：回顾性调查广西医科大学附属一院耳鼻喉科、眼科、整形科共３３６７例清洁伤口术的抗生素的使用情况。结果：９９．１％的病例术后常规应用抗生素，经统计学处理发现用药组与不用药组术后伤口感染率无显著性差异（术前应用抗生素达３天或３天以上的占本组例数的２０．４９％（６８４例），而用１～２天的也有５．６３％（１７９例）。术后联合应用３种抗生素预防感染达３５６例，用３种的也有２０例，分别占本组例数的１０．６７％和０．６０％。结论：围术期预防用药主要采用杀菌性抗生素是合理的，但存在预防性用药率过高、术前用药时间过长及不必要的联合用药等问题。眼科术后常规地全身性应用氨基糖甙类抗生素预防感染应是不合理的

Investigation of Preventive Use of Antibiotics for Clean Wounds in 3 367 Cases

OBJECTIVE: To get the information of use of antibiotics in preventing the clean wound infections and evaluate therationality. METHODS: The use of antibiotics for postoperative clean wounds in 3 367 cases from Departments of Plastic Surgery,Ophthalmology and ENT of The First Affiliated Hospital of Guangxi Medical University was reviewed. HESULTS: Antibiotics have beenadministrated as amatter of routine in 99. 1% of cases to prevent infection for clean wounds postoperatively. There was no statisticaldifference in wound infection between antibiotics used group and unused group. The percentages of preoperative use of antibiotics forthree or more days and for one to two days were 20. 49% (684 casesi and 5. 63% (179 cases) , respectively. There were 356 casesreceiving combined - use of two kinds of antibiotics and 20 cases receiving combined - use of three kinds of antibiotics for preventingwound infections, accounting for 10. 67% and 0. 60% of total cases of this series, respectively. CONCLUSION : It was rational to adoptbactericidal antibiotics as preventive drugs in perioperative period,however, the rate of use was unduly high,the course of antibiotics. Itseems to be irrational to systemically administrate aminoglycoside antibiotics after ophthalmological operations.