腹股沟疝无张力修补术应用抗生素与否随机对照研究

Early infection rates of tension-free inguinal hernia repair without prophylactic:a randomized controlled trial

目的探讨腹股沟疝无张力修补术是否需要常规预防性应用抗生素。方法按照随机对照的原则对2010年7月至2011年7月广东省人民医院血管甲状腺腹壁疝外科诊治842例成人腹股沟疝进行前瞻性研究分析。治疗组200例,术前一次性应用预防性抗生素;对照组642例术前未应用抗生素,对比两组术后早期感染发生率情况。结果 842例中共10例发生手术部位感染,其中治疗组2例(1%),对照组8例(1.2%),两组比较差异无统计学意义。比较两组术后第3天血白细胞计数、中性粒细胞比值、住院时间差异亦无统计学意义。结论无高危因素的成人腹股沟疝无张力修补术常规应用抗生素对预防术后手术部位感染并无实质必要。

Objective To investigate the feasibility of tension-free repair of inguinal hernia without antibiotic prophylaxis. Methods According to the principle of randomized controlled trial, a total of 842 cases of adult inguinal hernia treated from July 2010 to July 2011 in Department of Vascular-thyroid-abdominal wail-hernia Surgery, Guangdong Provincial People＇s Hospital were analyzed prospectively. The cases were divided into two groups （control group and trial group）. Cases in trial group （n=200） were treated by antibiotics once preoperatively while cases in control group （n=642） received no antibiotics treatment. The outcomes of early postoperative infection rates between two groups were compared. Results Among 842 cases, l0 cases （2 from trial group and 8 from control group） developed surgical site infection （SSI）. There was no significant difference in the infection rate with 1.0% for trial group vs. 1.2% for control group. No statistical difference was found in the results of complete white blood cell count, neutrophilic granulocyte ratio and hospital stays. Conclusion There is no real need to apply regular prophylactic antibiotics treatment for adult tension-free repair of inguinal hernia without high risk factors.