2016~2017年脊柱手术预防用药及术后感染情况分析(1)
摘 要：目的 分析我院脊柱手术抗菌药物预防使用情况，为临床合理用药提供依据。方法 选择2016年1月～2017年12月在我院进行脊柱手术的患者100例，根据预防用药时间分为观察组63例和对照组37例，记录切口大小、手术时间、术中出血量、住院天数、术后CRP、PCT及感染诊断。结果 观察组手术平均预防用药时间为(6.11±2.96)d。观察组与对照组的切口大小、术中出血量比较，差异无统计学意义(P>0.05);手术时间、住院天数观察组高于住院组，差异有统计学意义(P<0.05);两组手术感染率比较，差异无统计学意义(P>0.05)。结论 延长抗菌药物预防用药时间对于降低术后感染的发生并没有更多优势;可通过监测CRP、PCT及综合评估是否发生术后感染。
关键词：抗菌药物;预防用药;感染;脊柱手术
中圖分类号：R473.6 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.24.032
, http://www.100md.com
文章编号：1006-1959(2018)24-0112-03
Abstract：Objective To analyze the prophylactic use of antimicrobial agents in spinal surgery in our hospital and to provide evidence for rational use of antibiotics in clinic.Methods 100 patients undergoing spinal surgery in our hospital from January 2016 to December 2017 were selected.According to whether the time of prophylactic medication was longer than 24 h，they were divided into observation group (n=63) and control group (n=37). The incision size， operation time， intraoperative bleeding， hospital stay， postoperative CRP，PCT and infection diagnosis were recorded.Results The average prophylaxis time of the observation group was (6.11±2.96)d. There was no significant difference in the size of incision and intraoperative blood loss between the observation group and the control group (P>0.05). The operation time and hospitalization days were higher in the observation group than in the inpatient group， and the difference was statistically significant(P<0.05). There was no significant difference in the surgical infection rate between the two groups(P>0.05). Conclusion Prolonging the time of antibiotic prophylaxis has no more advantages in reducing the incidence of postoperative infection. It can be evaluated by monitoring CRP， PCT and comprehensively to determine whether postoperative infection has occurred.
, 百拇医药
Key words：Antibacterial agent Prophylactic antibiotics Infection
随着近几年抗菌药物专项整治工作的开展，我院Ⅰ类切口抗菌药物预防使用率从2011年接近100%下降至目前的27%～29%，但是，涉及骨科脊柱手术抗菌药物预防使用的疗程偏长，与《抗菌药物临床应用指导原则》[1]要求Ⅰ类切口预防用药<24 h的规定存在一定差距，亟待整改。本文通过调阅2016年1月～2017年12月共102例脊柱手术病例，对抗菌药物预防使用情况及术后感染的发生情况进行分析，以期对临床预防使用抗菌药物提供一定的参考意义。
1资料与方法
1.1临床资料 选择2016年1月～2017年12月在我院进行脊柱手术的患者共102例，纳入标准：①患者年龄≥18岁。②无其他感染性疾病，术前7 d无抗菌药物使用情况。③无精神疾病。排除标准：术前感染病例。最终入选100例。按照手术预防用药的时间将其分为两组，对照组为手术预防用药时间<24 h，共37例，其中男性15例，女性22例，年龄33～87岁，平均年龄(62.14±12.67)岁。包括腰椎椎板切除减压术9例，腰椎间盘切除伴椎板切除术9例，腰椎间盘髓核切除术2例，颈椎间盘切除术13例，颈椎间盘切除伴椎板切除术2例，胸椎间盘切除减压术2例。观察组为手术预防用药时间>24 h，共63例，其中男性27例，女性36例，年龄44～81岁，平均年龄(65.54±9.09)岁。包括腰椎椎板切除减压术31例，腰椎间盘切除伴椎板切除术13例，腰椎间盘髓核切除术4例，腰椎间盘髓核切除伴椎板切除术2例，颈椎间盘切除术8例，颈椎间盘切除伴椎板切除术1例，胸椎间盘切除减压术2例，颈椎后路单开门椎管减压术2例。两组病例患者的手术类别、性别、年龄比较，差异无统计学意义(P>0.05)，具有可比性。, 百拇医药(王蕊 陈金萍)
关键词：抗菌药物;预防用药;感染;脊柱手术
中圖分类号：R473.6 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.24.032
, http://www.100md.com
文章编号：1006-1959(2018)24-0112-03
Abstract：Objective To analyze the prophylactic use of antimicrobial agents in spinal surgery in our hospital and to provide evidence for rational use of antibiotics in clinic.Methods 100 patients undergoing spinal surgery in our hospital from January 2016 to December 2017 were selected.According to whether the time of prophylactic medication was longer than 24 h，they were divided into observation group (n=63) and control group (n=37). The incision size， operation time， intraoperative bleeding， hospital stay， postoperative CRP，PCT and infection diagnosis were recorded.Results The average prophylaxis time of the observation group was (6.11±2.96)d. There was no significant difference in the size of incision and intraoperative blood loss between the observation group and the control group (P>0.05). The operation time and hospitalization days were higher in the observation group than in the inpatient group， and the difference was statistically significant(P<0.05). There was no significant difference in the surgical infection rate between the two groups(P>0.05). Conclusion Prolonging the time of antibiotic prophylaxis has no more advantages in reducing the incidence of postoperative infection. It can be evaluated by monitoring CRP， PCT and comprehensively to determine whether postoperative infection has occurred.
, 百拇医药
Key words：Antibacterial agent Prophylactic antibiotics Infection
随着近几年抗菌药物专项整治工作的开展，我院Ⅰ类切口抗菌药物预防使用率从2011年接近100%下降至目前的27%～29%，但是，涉及骨科脊柱手术抗菌药物预防使用的疗程偏长，与《抗菌药物临床应用指导原则》[1]要求Ⅰ类切口预防用药<24 h的规定存在一定差距，亟待整改。本文通过调阅2016年1月～2017年12月共102例脊柱手术病例，对抗菌药物预防使用情况及术后感染的发生情况进行分析，以期对临床预防使用抗菌药物提供一定的参考意义。
1资料与方法
1.1临床资料 选择2016年1月～2017年12月在我院进行脊柱手术的患者共102例，纳入标准：①患者年龄≥18岁。②无其他感染性疾病，术前7 d无抗菌药物使用情况。③无精神疾病。排除标准：术前感染病例。最终入选100例。按照手术预防用药的时间将其分为两组，对照组为手术预防用药时间<24 h，共37例，其中男性15例，女性22例，年龄33～87岁，平均年龄(62.14±12.67)岁。包括腰椎椎板切除减压术9例，腰椎间盘切除伴椎板切除术9例，腰椎间盘髓核切除术2例，颈椎间盘切除术13例，颈椎间盘切除伴椎板切除术2例，胸椎间盘切除减压术2例。观察组为手术预防用药时间>24 h，共63例，其中男性27例，女性36例，年龄44～81岁，平均年龄(65.54±9.09)岁。包括腰椎椎板切除减压术31例，腰椎间盘切除伴椎板切除术13例，腰椎间盘髓核切除术4例，腰椎间盘髓核切除伴椎板切除术2例，颈椎间盘切除术8例，颈椎间盘切除伴椎板切除术1例，胸椎间盘切除减压术2例，颈椎后路单开门椎管减压术2例。两组病例患者的手术类别、性别、年龄比较，差异无统计学意义(P>0.05)，具有可比性。, 百拇医药(王蕊 陈金萍)