未预防性应用抗菌药物与甲状腺手术切口感染关系

Relationship Between Non-prophylactic Use of Antibiotics and Postoperative Wound Infection in Thyroid Surgery

[目的]探讨围手术期未预防性使用抗菌药物与非感染性甲状腺手术切口感染率的关系。[方法]回顾性分析某三甲肿瘤专科医院2012年1月至2014年12月期间1743例非感染性甲状腺手术患者资料,将围手术期未预防性应用抗菌药物患者1497例设为研究组,预防性应用抗菌药物患者246例设为对照组,调查两组切口感染情况、住院总费用、平均住院时间等,并进行对比。[结果]两组患者年龄、性别、疾病构成、手术持续时间、麻醉方式、切口感染率方面比较无显著性差异（P〉0.05）,平均住院总费用、平均住院时间比较差异有统计学意义（P〈0.05）。2012-2014年间非感染性甲状腺手术预防性使用抗菌药物使用比例明显下降（由48.3%降至0.9%）。[结论]围手术期未预防性使用抗菌药物并未增加非感染性甲状腺手术术后切口感染率。合理降低围手术期抗菌药物的使用,有助于减少患者的经济负担和治疗风险。

[Purpose] To investigate the relationship between non-prophylactic use of antibiotics and postoperative wound infection rate in thyroid surgery during the perioperative period. [Methods] A retrospective analysis was conducted on 1743 cases of non-infectious thyroid operation patients from Jan,2012 to Dec,2014,in which 1497 eases without prophylactic use of antibiotics were as the study group,and 246 patients with prophylactic use of antibiotics were as the control group.The incision condition,cost of hospitalization and the average hospitalization time were compared between these two groups. [Results] There was no significant difference in age,gender,disease constituent,operation duration,anesthesia method and incision infection rate between the two groups（P〈0.05）. There were statistically significant differences in the average hospital total cost and average hospitalization time（P〈0.05）,and during the year of 2012 to 2014,the prophylactic use of antibiotics rate decreased markedly from 48.3% to 0.9%. [Conclusion] No antimicrobial prophylaxis in thyroid surgery during perioperative period does not increase postoperative wound infections. Reasonable decreasing prophylactic use of antibiotics is helpful to decrease the economic burden and the risk of treatment of patients.