抗菌药物预防老年心包穿刺置管术后感染的临床研究

Clinical studies on the antibiotic prevention of infections in elderly patients after pericardiopuncture catheterization

目的探讨抗菌药物对老年心包积液患者行心包穿刺置管术后感染的预防效果,为临床心包穿刺置管治疗大量心包积液患者提供可行的方法,以预防感染的发生。方法选取2011年4月-2014年3月心包积液行心包穿刺置管术老年患者120例,将其随机分为A、B两组,A组58例患者给予常规治疗,发生感染后给予广谱抗菌药物治疗,并行细菌培养,根据结果选择敏感抗菌药物治疗;B组62例患者给予预防性应用头孢唑林及甲硝唑治疗,比较两组患者心包感染以及穿刺部位感染、住院时间、住院费用。结果 A组患者心包感染和穿刺部位感染发生率分别为6.90%和10.34%,B组患者无心包感染,穿刺部位感染发生率为1.61%,两组比较差异有统计学意义(P<0.05);A组患者住院时间和住院费用分别为(11.33±2.81)d和(6 929.82±436.39)元,B组患者分别为(8.78±1.09)d和(4 832.84±335.28)元,两组比较差异有统计学意义(P<0.05)。结论通过预防性应用抗菌药物,心包积液老年患者行心包穿刺置管术后感染发生率均明显降低,表明行心包穿刺置管术进行治疗的老年患者实施抗菌药物预防性应用效果良好。

OBJECTIVE To investigate the preventive effect of antimicrobial drugs on treating infections on elderly patients after pericardiopuncture catheterization so as to provide feasible method for treating hydropericardium and to avoid infections .METHODS Totally 120 cases of elderly patients received pericardiopuncture catheterization from Apr .2011 to Mar .2014 were chosen and divided into two groups .Group A with 58 cases were treated with regular therapy and were given broad‐spectrum antibiotics when found to be infected .Bacteria cultivation was con‐ducted and the results were taken into consideration to choose sensitive antibiotics .Group B with 62 cases were given preventive cefazolin and metronidazole .The condition of pericardial infection and puncture site infection ,du‐ration of hospitalization and the expenses were compared in the two groups .RESULTS The infection rate of pericar‐dial infection and wound infection in patients in group A were 6 .90% and 10 .34% .No cases in group B suffered from pericardial infection and the rate of puncture site infection was 1 .61% .The difference was significant （P〈0 .05） .In group A ,the length of hospital stay was （11 .33 ± 2 .81）d and the cost was （6 929 .82 ± 436 .39）yuan . The number in the group B were （8 .78 ± 1 .09）d and （4 832 .84 ± 335 .28）yuan .The difference was significant （P〈0 .05） .CONCLUSION The prophylactic use of antimicrobial drugs can obviously reduce the rate of infection in elderly patients with hydropericardium after pericardiopuncture catheterization ,hence should be applied in clinic treatments .