腹股沟嵌顿疝一期无张力修补术中不使用抗生素的临床观察

Clinical research of no use of antibiotics in patients undergoing tension-free repair with incarcerated inguinal hernia

目的探讨腹股沟嵌顿疝行一期无张力修补术围手术期不使用抗生素的安全性。方法根据随机数字表将合肥市第二人民医院普外科2011年1月至2013年7月326例因腹股沟嵌顿疝行一期无张力修补术患者分为观察组（围手术期不使用抗生素组）192例，对照组（围手术期使用抗生素组）134例。并比较两组术后早期切口感染，以及患者术后白细胞计数及中性粒细胞计数。结果对照组和观察组术后切口红肿发生率、切口感染率差异均无统计学意义[7．29％（14／192）比3．73％（5／134）、0．52％（1／192）比1．49％（2／134），均P〉0．05]。对照组与观察组术后第3天白细胞计数和中性粒细胞计数差异也均无统计学意义[（7．9±0．6）×109/L比（7．8±0．7）×109／L，（4．9±0．5）×109／L比（5．0±0．5）×109／L，U=1．344、1．777，P=0．180、0．077]。结论无高危人群嵌顿性腹股沟疝肠管无坏死时行一期无张力修补术使用抗生素并无必要。

Objective To explore the safety in inguinal incarcerated hernia repair without use of antibiotics. Methods Retrospective statistical analysis was performed for a total 326 patients with inguinal incarcerated hernia repair at our hospital from January 2011 to July 2013. They were divided into 2 groups of non-using （ n = 192） and using （ n = 134） antibiotics. Statistical analysis of early postoperative infection was performed for two groups. Results The total incision infection had no statistical difference between two groups （7.29% （14/192） vs 3.73% （ 5/134 ）, 0. 52% （ 1/192 ） vs 1.49% （ 2/134 ）, both P 〉 0. 05 ）. Further comparison of leukocyte count and neutrophil count at Day 3 showed no inter-group statistical difference （（7.9±0.6） x109vs（7.8±0.7） ×109/L, （4.9±0.5） ×109vs（5.0±0.5） ×109/L; U= 1. 344, 1. 777 ; P = 0. 180, 0. 077 ）. Conclusion It is unnecessary to use preventive antibiotics in patients undergoing tension-free repair with incarcerated inguinal hernia without high-risk infection or bowel necrosis.