3种头孢菌素预防Ⅰ类切口感染的疗效及经济性比较

Comparison of the efficacy and economy among 3 cephalosporins in typeⅠincision operation during perioperative period

目的：比较头孢硫脒、五水头孢唑啉及头孢唑啉对预防Ⅰ类切口手术（疝、乳腺及甲状腺手术）围手术期感染的疗效及经济性。方法2012年3月至9月，行以上3种Ⅰ类切口手术且术前预防用头孢硫脒、五水头孢唑啉或头孢唑啉的患者总共78例，根据预防用药的种类分为A、B和C3组，用法均为手术前30min静脉滴注1次，用量为2．0g，术后用量为2．0g，2次/日，术后使用1～4d。比较3组预防感染的疗效及经济性。结果3组患者术后均未发生感染，体温、白细胞计数、中性粒细胞百分比差异无统计学意义（P＞0．05），也未见药品不良反应；人均每日抗菌药物费用及住院总费用3组间差异具有统计学意义（P＜0.05）。结论头孢硫脒、五水头孢唑啉及头孢唑啉在预防Ⅰ类切口感染方面的疗效相当，但经济性差异有统计学意义，头孢唑啉经济性最佳。

Objective To compare the efficacy and economy among cefathiamidine ,pentahydrate cefazolin and cefazolin in 3 type Ⅰ incision operation（surgery of hernia ,breast and thyroid） during perioperative period .Methods During March to September of 2012 ,there were 78 patients who accepted the operations and used the 3 medicines in our hospital .According to the use of medicines ,the patients were divided into group A （cefathiamidine） ,B （pentahydrate cefazolin） and C （cefazolin） .Patients were given the drug 2.0 g before the preoperation 30 min and after the surgery ,2.0 g ,iv ,bid ,lasting 1-4 days .The clinical effect and economy of the 3 groups were compared .Results No infection occurred after the operation .The body temperature ,WBC ,and NEUT% had no statistical difference among the 3 groups patients（P 〉 0.05） .Drug adverse reactions were not found in all the patients .But there was significant statistical difference between the mean cost of antibiotics and the total medical cost among the 3 groups （ P 〈0.05） .Conclusion Cefathiamidine ,pentahydrate cefazolin and cefazolin have the same efficacy of prevention of type Ⅰ incision infection ,but the economy of the 3 medicines has statistical difference ,and cefazolin is the best choice .