血管内介入治疗围手术期抗菌药物应用的前瞻性研究

Prophylactic Antibiotic Usage for Vascular Interventional Procedures: A Prospective Investigation

目的探讨术前无感染者血管内介入手术围术期是否需要预防性应用抗菌药物。方法以随机分组前瞻性研究方法调查98例、115例次血管内介入手术患者,术前采用随机数字法分为预防性应用抗菌药物组(预防组)和无预防性应用抗菌药物组(无预防组);预防组55例在术前30 min静脉应用头孢唑林2 g,非预防组60例术前不用抗菌药物,两组术后均不再用抗菌药物;比较两组术后感染率。结果两组共35例患者出现发热,其中预防组16例,非预防组19例,该35例中10例患者出现白细胞数升高,其中预防组4例,非预防组6例;预防组感染1例,诊断为败血症,感染率1.9%;非预防组同样1例感染,诊断为败血症,感染率为1.7%,两组术后感染率比较差异无统计学意义。结论术前无感染者血管内介入手术围术期没有必要使用抗菌药物预防术后感染。

OBJECTIVE To investigate in a prospective randomized trial the necessary of prophylactic antibiotic usage for vascular interventional procedures in patients without infection before operation.METHODS Ninety-eight patients（with 115 vascular intervention procedures） without infection before operation were randomizedly divided into two groups.Among them,14 procedures for angiography,22 for transcatheter arterial infusion（TAI） and 79 for transcatheter arterial chemo-embolization（TACE）.The patients in group A（55 procedures） received prophylactic antibiotic（one dose of cefazolin 2g iv 30 min before the procedure）,while patients in group B（60 procedures） received no prophylactic antibiotics usage.The infection rates in two groups were compared.RESULTS Fever（axillary temperature over 37.5℃） occurred in 35 pationts,16 and 19 cases were in groups A and B,respectively.Elevated WBC count（10 000/μl） was found in 10 procedures,4 and 6 were in groups A and B.One case was diagnosed as sepsis in both groups respectively.The infection rates were 1.9% in group A,and 1.7% in group B.There were no statistically significant difference in the infection rates between the two groups（P0.05）.CONCLUSION Prophylactic antibiotics is not necessary for vascular interventional procedure in the condition without pre-procedure infection.