颌面Ⅰ类切口围手术期抗菌药物合理使用的临床研究

Clinical study on rational use of antibiotics during perioperative period of type Ⅰ incision maxillofacial operation

目的研究颌面外科Ⅰ类切口围手术期抗菌药物合理使用。方法对2009年9月-2011年8月颌面Ⅰ类切口297例,按手术时间、是否使用抗菌药物分为4组,比较4组切口感染率,探讨抗菌药物使用合理性。结果手术时间>2h,术前用药组切口感染率为1.11%,术后长期用药组为7.78%,差异有统计学意义(P<0.05);手术时间<2h,未用药组感染率为3.39%,术前用药组为3.45%,差异无统计学意义。结论颌面外科Ⅰ类切口,手术时间>2h,术前用药可替代术后长期用药,手术时间<2h,围手术期可不使用抗菌药物。

OBJECTIVE To explore the rational use of antibiotics during the perioperative period of type Ⅰ incision maxillofacial operation.METHODS A total of 297 patients who underwent type Ⅰ incision operation from Sep 2009 to Aug 2011 were divided into 4 groups according to the status using antibiotics;the incidence rates of incision infections of the four groups were compared,and the rationality of using antibiotics was evaluated.RESULTS The incidence rate of incision infections in the patients with the operation duration more than 2 hours and the use of antibiotics was 1.11%,the patients with long-term use of antibiotics after the operation was 7.78%,the difference was statistically significant（P0.05）;the incidence rate of the incision infections in the patients with the operation duration less than 2 hours and without use of antibiotics before operation was 3.39%,the patients using antibiotics before the operation was 3.45%,the difference was not statistically significant.CONCLUSION The preoperative medication may be an effective alternative to the postoperative long-term medication in the type Ⅰ incision maxillofacial operation if the operation duration is more than 2 hours,and antibiotics should not be applied during the perioperative period if the operation duration is less than 2 hours.