胃癌手术患者抗菌药物使用及对术后感染的影响

Impact of use of antibiotics on postoperative infections in gastric cancer patients

目的探讨胃癌手术患者抗菌药物的使用策略及其对术后感染的影响,为临床抗菌药物使用策略的制定提供参考。方法选取2009年6月-2013年6月在医院接受胃癌切除术的患者196例,随机分为观察组和对照组各98例;对照组患者在术后24h内静脉滴注头孢西丁预防感染,观察组在术前30min肌内注射头孢西丁,比较两组患者术后感染率,数据采用SPPS 17.0进行软件分析。结果患者术后感染率观察组为3.06%、对照组为15.31%,观察组术后感染率显著低于对照组(P<0.05);观察组培养出病原菌3株,耐药率为0,对照组培养出病原菌15株,耐药率为80.00%,观察组病原菌的耐药率显著低于对照组(P<0.05)。结论优化胃癌手术围手术期抗菌药物使用策略有利于降低胃癌术后感染的发生率,减少耐药菌株的产生,值得临床进一步推广应用。

OBJECTIVE To explore the strategies for use of antibiotics and observe the impact on postoperative in‐fections in the gastric cancer patients so as to provide guidance for development of the strategies for clinical use of antibiotics .METHODS A total of 196 gastric cancer patients who underwent the gastrectomy from Jun 2009 to Jun 2013 were enrolled in the study and randomly divided into the observation group and the control group ,with 98 ca‐ses in each .The control group was treated with the intravenous drip of cefoxitin within 24 hours after the surgery , while the observation group was given the intramuscular injection of cefoxitin at 30 min before the surgery .The incidence of postoperative infections was compared between the two groups of patients ,and the statistical analysis of data was performed with the use of SPSS 17 .0 software .RESULTS The incidence of postoperative infections was 3 .06% in the observation group ,significantly lower than 15 .31% in the control group （P〈0 .05） .Totally 3 strains of pathogens were cultured from the observation group ,15 strains from the control group .The drug resist‐ance rate of the pathogens isolated from the observation group was 0 ,significantly lower than 80 .00% of the pathogens isolated from the control group （P〈0 .05） .CONCLUSION It is an effective way to optimize the use of antibiotics during the perioperative period of gastrectomy so as to reduce the incidence of the postoperative infec‐tions and reduce the drug‐resistant strains ,which is worthy to be promoted in the hospital .