骨科患者围术期应用抗菌药物对预防感染及炎症因子水平的影响

Effect of perioperative antibiotics on the prevention of infection and inflammatory factors in orthopedic patients

目的探讨骨科患者围术期应用抗菌药物对预防感染及炎症因子水平的影响。方法选择2017年1月～2018年6月我院收治的40例骨科患者作为研究对象,按照患者是否接受药物干预,将所有入选患者分为研究组(n=20)和对照组(n=20)。在患者围术期间,对照组给予常规抗菌药物治疗,研究组给予干预性抗菌用药。比较两组患者的给药率、切口感染率、药物不良反应总发生率、使用抗菌药物合理情况以及两组患者治疗前后炎症因子水平。结果研究组患者的手术切口感染率显著低于对照组,差异有统计学意义(P<0.05)。研究组患者的不良反应总发生率显著低于对照组,差异有统计学意义(P<0.05)。研究组患者的药物选用、给药时间、用法用量、适应证、禁忌证合理率均明显高于对照组,差异有统计学意义(P<0.05)。研究组患者治疗后的肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、C反应蛋白(CRP)水平均显著低于对照组,差异有统计学意义(P<0.05)。结论骨科患者围术期采用干预性抗菌用药,能减少临床不规范用药,预防术后的细菌感染,控制炎症因子水平,提高患者的治疗安全性。

Objective To explore the effect of perioperative antibiotics on the prevention of infection and inflammatory factors in orthopedic patients. Methods Forty cases of patients admitted to the department of orthopedics in our hospital from January 2017 to June 2018 were selected as the research subjects. All patients were divided into the study group(n=20) and the control group(n=20) according to whether the patients received pharmaceutical intervention. During the perioperative period, the control group was given conventional antibiotics, and the study group was given interventional antibacterial medication. The rates of drug delivery, incision infection, the total incidence of adverse drug reactions and rational use of antibiotics between the two groups were compared, and levels of inflammatory factors before and after treatment were compared between the two groups. Results The infection rate of surgical incision in the study group was significantly lower than that in the control group, and the difference was statistically significant(P<0.05).The total incidence of adverse reactions in the study group was significantly lower than that in the control group, and the difference was statistically significant(P<0.05). The reasonable rates of drug selection, administration time, usage and dosage, indications and contraindications of the study group were significantly higher than those of the control group, and the differences were statistically significant(P<0.05). The levels of tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), interleukin-8(IL-8), and C-reactive protein(CRP) in the study group were significantly lower than those in the control group, and the differences were statistically significant(P<0.05). Conclusion For orthopedic patients, intervention antibacterial drugs can reduce the clinical nonstandard drug use, prevent the postoperative bacterial infection, control the level of inflammatory factors and improve the safety of the patients.