腹腔镜附件包块手术预防性抗菌素应用研究

目的：观察妇科腹腔镜附件包块切除术后手术部位感染情况，探讨该类手术预防性使用抗菌药物的必要性。方法选择妇科行腹腔镜附件包块切除术、符合条件的患者94例，术前随机分为2组：A组术前不用抗菌药物；B组术前使用第二代头孢菌素1次。根据2组患者术中情况，若无异常则术后不使用抗菌药物；若存在明显盆腔炎症表现，则术后补充使用抗菌药物，用药时间最长不超过术后48 h，观察比较不同用药方案与术后感染之间关系。结果94例患者成功完成腹腔镜下手术，术后体温≥38℃者4例，A组2例；B组2例，结合血常规检查不支持感染征象。随访观察至术后1个月，2组均无手术部位感染发生。结论对于无合并症的单纯妇科腹腔镜附件包块切除术，手术部位感染发生率低，围手术期无需常规预防性使用抗菌药。

Exploration of prophylactic antimicrobial use in gynecological laparoscopic adnexal surgery

Objective To observe the surgical site infection of gynecological laparoscopic adnexal surgery ,and to explore the necessity of prophylactic antibiotics use for such surgery .Methods 94 patients scheduled for gynecological laparoscopic adnexal surgery were selected and randomly divided into two groups before surgery ：no preoperative prophylactic antibiotics was used in group A;and in group B ,a single dose of the second-generation cephalosporins was applied .The use of antibiotics was dependent on the condition of the two groups of patients during the operation .No postoperative antimicrobial agents were used unless obvious pelvic inflammatory disease occurred ,and the use of postoperative antimicrobial agents was limited to 48 hours after operation .The relation between different regimens and the occurrence of postoperative infection was closely observed .Re-sults All the 94 patients went through laparoscopic surgery successfully .Postoperative fever was observed in 4 cases：2 cases in group A and 2 in group B, but routine blood tests did not support infection .All the patients were followed up for a month . No surgical site infection occurred .Conclusion For simple gynecological laparoscopic adnexal surgery without complications , the incidence of surgical site infection is low ,and there is no significant difference between the perioperative prophylactic anti -biotics group and the non-drug group.