椎间盘介入微创手术预防性使用抗菌药物回顾性研究

Antimicrobial prophylaxis for intertebral disk minimally invasive surgery:a retrospective study

目的探讨椎间盘介入微创手术围术期是否需要预防性应用抗菌药物。方法以回顾性研究方法调查医院2011年7-12月653例椎间盘介入微创手术患者围术期预防应用抗菌药物的情况,以围术期是否预防使用抗菌药物分为预防用药组和无用药组;分析围术期用药的合理性,比较两组术后感染发生情况。结果椎间盘介入微创手术围术期抗菌药物使用率为49.0%,其中左氧氟沙星、甲硝唑的使用率分别占93.4%和82.5%;联合使用占85.9%;给药时机均为术后静脉给药,两组术后均无手术部位感染发生。结论给药时机不规范,药物选择无针对性是手术围术期预防用药较普遍突出的问题,椎间盘介入微创手术不必预防性使用抗菌药物。

OBJECTIVE To investigate the necessary of prophylactic use of antibiotics for intervertebral disk minimally invasive surgery. METHODS A retrospective study was carried out in patients undergoing intervertebral disk minimally invasive surgery from Jul to Dec 2011. A total of 653 patients were divided into two groups. The patients in group A （320） received prophylactic antibiotic, while The patients in group B （333） received no prophylactic antibiotics usage. The rationality of prophylactic antibiotics usage was evaluated. The infection rates of the two groups were compared. RESULTS The utilization rate of prophylactic antibiotics was 49.0%, the utilization rates of levofloxacin and metronidazole were 93.4M and 82.5%, respectively; the combination use of antibiotics accounted for 85.9 %; all the drug administration timing were postoperative intravenous injection, and there were no surgical site infections in both groups. CONCLUSION The drug administration timing is not standard,the untargeted choice of antibiotics is prevalent during the perioperative period of the surgery, and the antibiotics prophylaxis is not necessary for the intervertebral disk minimally invasive surgery.