腹腔镜阑尾切除患者围手术期抗生素应用时间对并发症发生率的影响分析

目的分析腹腔镜阑尾切除患者围手术期抗生素使用持续时间对并发症发生率的影响。方法回顾性分析我院2012年7月～2017年6月腹腔镜阑尾切除患者836例。根据术后抗生素不同应用持续时间将患者分为三组:A组186例患者术后使用抗生素少于2天,B组404例患者术后使用抗生素治疗2～4天,C组246例患者术后使用抗生素治疗4天以上。比较3组患者术后切口愈合情况及抗生素使用相关性腹泻的发生率。结果三组患者术后切口达到甲级愈合患者分别为77.96%、76.24%和80.89%,三组之间差异不显著(P0.05);三组患者手术切口感染率2.69%、1.98%和2.44%,3组之间切口感染率无明显差异(P0.05)。但抗生素使用相关性腹泻随抗生素使用时间延长而增加。结论腹腔镜阑尾切除患者围术期抗生素使用持续时间对切口感染发生率无明显影响,但使用时间延长增加患者抗生素使用相关腹泻的发生率。

Analysis of the effect of perioperative antibiotic application time in patients undergoing laparoscopic appendectomy on the incidence of complication

Objective To analyze the effect of perioperative duration of antibiotic use on the incidence of complications in patients undergoing laparoscopic appendectomy. Methods 836 patients with laparoscopic appendectomy from July 2012 to June 2017 in our hospital were analyzed retrospectively， and the patients were divided into 3 groups according to different duration of antibiotics：186 patients as group A treated with antibiotics for less than 2 days after postoperation，404 as group B treated with antibiotics for 2-4 days，and 246 as group C treated with antibiotics for more than 4 days. The wound infection and incidence of diarrhea by using antibiotic were compared between the 3 groups. Results The proportions of patients with surgical incision achieving grade A healing were 77.96% ，76.24% and 80.89%，respectively，and the difference among group A，group B and group C was not significant（P> 0.05）. The infection rate of wound incision in the three groups was 2.69%，1.98% and 2.44%. There was no significant difference in the infection rate between the three groups （P>0.05）. However，antibiotic userelated diarrhea increases with prolonged use of antibiotics. Conclusion Perioperative duration of antibiotic use in patients undergoing laparoscopic appendectomy has no significant effect on the incidence of wound infection，but prolonged use increases the incidence of antibiotic?associated diarrhea in patients.