腹股沟疝修补术围手术期抗菌药物使用合理性调查

目的评价我院外科腹股沟疝修补术围手术期抗菌药物使用合理性.方法根据临床路径纳入或退出的标准,选取2007年7月至2012年7月行腹股沟疝修补术住院患者归档病历400例,分成8组进行用药合理性分析.结果术前不预防使用与术前预防使用非限制类或限制类抗菌药物,在术后抗菌药物有效率和再次手术率,差异无统计意义(P >0.05),而且术前使用抗菌药物组的平均最高体温、术后平均退热时间、术后耐药率、切口感染发生率或二重感染率、平均住院天数及平均住院费用上明显比不使用抗菌药物组高.结论腹股沟疝修补术围手术期不需预防使用抗菌药物,术后首选非限制类、窄谱抗菌药物.

Rationality Investigation Perioperative Application of Antibiotics in Inguinal Herniorrhaphy

Objective To evaluate the rational application of antibiotics for perioperative period of inguinal herniorrhaphy in a hospital. Methods According to the standard of clinical pathway into or exit, the archiving medical records of 400 hospitalized patients who underwent inguinal hernia repair operation in the period of 2007-07～2012-07 were selected and randomly divided into 8 groups, to analyze the rational application of medication. Results The efficiency rate of antimicrobials after the operation and reoperation rate had no significantly difference between patients that were treated with preventive prophylactic non-restricted or restricted antimicrobials (P>0.05). The average maximum temperature of patients in the preoperative application of antibacterials group, the average duration of pyretolysis after operation, the resistance after operation, the wound infection rate or supper infection rate, average hospitalization days and hospitalization expenses were significantly higher than patients that were not treated with antimicrobials.Conclusion Perioperative application of antibiotics in inguinal herniorrhaphy is unnecessary. Non-restricted and narrow-spectrum antimicrobials are the first choice for patients after operation.