230例经腹腔镜胆囊切除术患者应用抗生素的成本-效果分析

Cost-effectiveness Analysis of the Antibiotic Application in 230 Patients Undergoing Laparoscopic Chole-cystectomy

目的 :探讨经腹腔镜胆囊切除手术患者的抗生素合理应用。方法 :回顾调查了单纯择期腹腔镜胆囊切除手术病例的抗生素应用情况。230例病例分为4组 :A组 :围手术期用药 ;B组 :术前3d～7d +围手术期用药 ;C组 :围手术期用药 +术后2d～7d ;D组 :术前2d～7d +围手术期用药 +术后2d～7d。比较其疗效、住院天数及住院费用。结果 :A、B、C、D组在疗效比较上无显著性差异 ,而平均住院天数和平均住院费用除B、C组间无差异外 ,其他各组间比较有显著性差异 ,以A组的两项指标最低 ,具有最佳的成本 -效果比。结论 :预防性应用抗生素在腹腔镜胆囊切除手术中具有临床意义 ;以单纯围手术期用药为最佳 ;抗生素的选用仍以头孢唑啉为宜。

OBJECTIVE:To explore the rational use of antibiotics in patients undergoing laparoscopic cholecystectomy(LC) METHODS:The antibiotic use in the selected operation patients was retrospectively studied 230 patients were divided into four groups A group:Perioperative administration of drug;B group:Preoperative administration for 3 to 7 days and perioperative administration;C group:Perioperative administration and postoperative administration for 2 to 7 days;D group:Preoperative administration for 2 to 7 days,perioperative administration and postoperative administration for 2 to 7 days Four groups were compared about the efficacy,length of hospital stay and hospitalization expenses RESULTS:There were no significant differences in efficacy among A,B,C,D and in average length of hospital stay and hospitalization expenses between A and D groups A group was the lowest in two indices and had the best cost-effectiveness ratio CONCLUSION:There is clinical significance of preventive antibiotic application in LC patients;perioperative use is the best choice;Cefazolin is the first choice