腹部手术应用短程抗生素预防手术区感染的疗效分析

目的观察抗生素长、短程用药方法预防外科手术区感染的效果.方法全国15家医院进行多中心前瞻性随机对照研究.731例腹部外科手术患者被随机分为2组围手术期短程用药组(术后用药1d)及长程用药组(术后用药3d)预防手术区感染.2组患者在年龄、性别及手术种类等方面均无差异.预防用抗生素为奈替米星或合并使用甲硝唑.结果短程用药组感染率为0.84%(3/358),长程用药组感染率为2.68%(10/373),2组差异无显著性意义(P＞0.05).结论围手术期短程应用抗生素即可有效预防术后手术区感染,从药物经济学和合理用药的角度来说也优于长期用药.

Short-term versus long-term antimicrobial prophylaxis in abdominal surgery: a multicenter open randomized comparative trial

Objective To evaluate the outcome of short- term antimicrobial prophylaxis versus long-term in surgical site infection( SSI). Methods 731 patients undergoing abdomina l operation from 15 hospitals were randomly divided into 2 groups. 358 patients were enrolled in the short-term group (24 h), and 373 patients in the long-ter m group (72 h). There was no difference between the 2 groups with regard to ag e, sex, and types of operation. Netilmicin was used alone or in combination with metronidazole. Results The rates of SSI in th e short-term and long-term groups were 084% and 268% ( P>005), re spectively. Conclusions The results demonstrat ed that the short-term antimicrobial agents prophylaxis is effective in the pre vention of post-operative SSI. The long-term one act does not better than the short-term in terms of rationality and pharmacoeconomics.