抗菌药物使用与结直肠癌术后切口感染的相关性研究

Relationship between application of antibiotics and surgical site infection after colorectal cancer surgery

目的探讨结直肠癌患者术后抗菌药物使用情况与手术切口感染的关系。方法回顾性分析了2003年2月-2010年12月收治的547例结直肠癌患者病例资料,按手术切口感染情况分为A组:切口感染组105例,B组:切口无感染组442例,比较2组患者抗菌药物使用时间及联合用药情况,再将所有患者按抗菌药物使用时间分为:>72h组和<72h组,比较2组切口感染率。结果 A组术后用药时间高于B组,差异有统计学意义(P<0.05);2组抗菌药物用药方案差异无统计学意义,抗菌药物使用时间>48h组的切口感染率,高于抗菌药物使用时间<48h组,但差异无统计学意义。结论结直肠癌患者手术切口感染,是一个多因素相互作用的过程,增加抗菌药物的使用时间和多联合用药并不能使切口感染率下降,外科医师应该增强合理用药的意识。

OBJECTIVE To discuss the relationship between antibiotic and surgical site infection（SSI） in colorectal cancer.METHODS A survey of 547 patients with colorectal cancer from Feb 2003 to Dec 2010 was carried out.Patients were divided into two groups by SSI：group A,SSI（＋）,105 patients;group B SSI（-）,442 patients.the differences of the time of prophylactic antiboitics and the kinds of antibiotics were compared.Then the patients were divided into another two groups by the time of prophylactic antibiotics： the time was over 72 hours and the time was less than 72 hours,The infection rates of SSI were compared.RESULTS Compared with group B,group A had longer time use of antibiotics（P〈0.05）,there were no significant difference between the two groups.There were more infection ratio in the group with using antibiotic over 72 hours than that with using time less than 48h,but the difference was not statistically significant.CONCLUSION SSI is a process not only involved with antibiotic but also a lot of factors.Doctors should use antibiotic more reasonably,for moreover prolonged antibiotic prophylax and combination of more kinds of antibiotics can not decrease the incidence of SSI.