预防性使用抗生素时间与结直肠癌手术切口感染的关系

Relation Between Using Time of Prophylactic Antibiotics and Surgical Site Infection in Colorectal Cancer

目的探讨结直肠癌患者预防性使用抗生素与术后手术切口感染之间的关系。方法回顾性分析1998年1月至2008年12月期间成都市第一人民医院肛肠科专业组收治880例确诊为结直肠癌的患者的临床资料,按照抗生素使用时间将患者分为≥24 h组(n=401)和<24 h组(n=479),比较2组患者手术切口感染的发生率。结果在有切口感染的患者中,手术时间明显延长(P=0.04),出血量更多(P=0.03),抗生素使用时间更长(P=0.04)。在结肠癌手术中,有、无切口感染的患者其手术时间的差异有统计学意义(P=0.01)。而直肠癌手术中,有、无切口感染的患者其手术时间、出血量以及抗生素使用时间差异无统计学意义(P>0.05)。结论手术时间越长或术中出血越多的患者术后越易发生切口感染,而延长抗生素使用时间并不能降低手术切口感染率。

Objective To discuss the relationship between antibiotic prophylaxis and surgical site infection（SSI） in colorectal cancer.Methods A survey of 880 patients with colorectal cancer from Jan.1998 to Dec.2008 were studied.Patients were divided into two groups by antibiotic duration： ≥24 h group（n=401） and 24 h group（n=479）.To compare the differences of surgical site infection between two groups.Results For SSI patients,operation time obviously prolonged（P=0.04）,or with more blood loss（P=0.03） and longer time use of antibiotics（P=0.04）.In colon cancer patients with SSI operation time was significantly different from the cases of colon cancer without SSI（P=0.01）,while there was no difference between SSI and operation time,blood loss and duration of antibiotics（P0.05）.Conclusion Longer operation time,more blood loss and longer bleeding time are the risk factors of surgical site infection.Moreover prolonged antibiotic prophylaxis can not decrease the incidence of SSI.