陕西省1066例乳腺病损切除术患者预防性使用3种头孢菌素的比较研究

Comparative Study on the Preventive Use of 3 Kinds of Cephalosporins for 1 066 Patients with Breast Lesion Resection in Shaanxi Province

目的:比较预防性使用3种不同抗菌药物对乳腺病损切除术患者预后的影响。方法:选取陕西省12家医院乳腺病损切除术患者1 066例,按随机数字表法分为试验组(360例)、对照A组(352例)、对照B组(354例)。试验组患者给予一代头孢菌素头孢唑林,对照A组患者给予二代头孢菌素头孢呋辛,对照B组患者给予三代头孢菌素头孢哌酮钠他唑巴坦钠。3组患者上述药品所用剂量均为每次2 g加入0.9%氯化钠注射液100 ml中,ivgtt,术前0.5 h给药。其中,试验组患者术后给药时间≤24 h。观察3组患者术后不良反应、手术切口愈合情况、感染情况、住院时间、人均药品费用等指标。结果:3组患者手术切口甲级愈合率、术后感染率比较,差异均无统计学意义(P>0.05);观察组患者术后不良反应发生率、住院时间、人均药品费用明显低于或短于对照A、B组,差异均有统计学意义(P<0.05)。结论:头孢唑林较头孢呋辛和头孢哌酮钠他唑巴坦钠能降低患者术后不良反应、减少抗菌药物人均费用及住院药品人均费用,缩短住院时间。

OBJECTIVE：To compare the effects of prophylactic application of 3 different antibiotics on prognosis in patients underwent breast lesion resection. METHODS：1 066 patients with breast lasion resection from 12 hospitals of Shaanxi province were divided into trial group（360 cases）,control group A（352 cases）and control group B（354 cases）according to random num-ber table. Trial group was given first generation cephalosporin cefazolin;control group A was given second generation cephalospo-rin cefuroxime;control group B was given third generation cephalosporin cefoperazone sodium and tazobactam sodium. The dosage regimens of 3 groups were as follows：relevant drug 2 g added into 0.9%Sodium chloride injection 100 ml,ivgtt,0.5 h before sur-gery,medication course≤24 h after surgery in trial group. Those indexes of 3 groups were observed,such as post-operative ADR, incision healing,infection,hospitalization duration,phamaceutical costs per capita. RESULTS：There was no statistical signifi-cance in the rate of incision healing and the rate of post-operative infection among 3 groups（P〉0.05）. The incidence of post-opera-tive ADR,hospitalization duration and phamaceutical costs per capita in observation group were significantly lower or shorter than in control group A and B,with statistical significance（P〈0.05）. CONCLUSIONS：Cefazolin is better than cefuroxime and cefo-perazone sodium and tazobactam sodium to reduce the postoperative adverse reaction,antibiotics cost per capita and hospital drug cost per capita,shorten the hospitalization duration.