阿米卡星切口内注射预防重症阑尾炎切口感染分析

Prevention Effects of Intra-incisiona Amikacin on Postoperative Wound Infections of Severe Appendicitis

目的分析阿米卡星切口内注射预防重症阑尾炎手术切口感染的效果。方法选用化脓性、坏疽性、穿孔性以及阑尾周围脓肿的重症阑尾炎患者156例，随机分为两组，同法切除阑尾，缝合腹膜后，试验组碘伏擦洗后用阿米卡星均匀浸润注射在手术切口内肌层及皮下层；对照组碘伏擦洗、甲硝唑浸泡切口3～5min，同法逐层缝合切口。结果两组病例的年龄、性别、发病时间、术后病理分型差异无统计学意义（P〉0．05），试验组切口感染1例（1．28％）显著低于对照组切口感染8例（10.26％）（P〈0．05）。结论阿米卡星切口内注射可有效预防重症阑尾炎手术切口感染的发生。

OBJECTIVE To analyze the prevention effects of amikacin on postoperative wound infections in severe appendicitis by intra-incisional injection. METHODS A total of 156 severe appendicitis patients with suppuration, gangrenous, perforation and periappendiceal abscess were divided into two groups randomly. The patients in study group underwent the same appendectomy, and then were infiltrated and injected with 0. 4g amikacin plus 5ml sodium chloride into muscular layer and stratum subcutaneum around incisions after suture of peritoneum; while the patients in control group were scrubbed with polividone iodine （Idophor） and soaked with metronidazole for 3-5 min on incisions. The incisions were sutured layer by layer using the same method. RESULTS There was no significant difference between two groups in age, sex, onset time and pathological type after operation （P〉0.05） ; the infection rate of incision in study group （1.28%）was lower than that in control group （10.26%） significantly （P〈0.05）. CONCLUSIONS Postoperative wound infections in severe appendicitis could be prevented effectively by the injection of amikacin into incision.