我院2013-2015年未预防性应用抗菌药物的小儿腹股沟疝修补术术后发热及感染情况分析

Fever and Infection in Children after Non-Prophylactic Use of Antibiotics in Pediatric Inguinal Hernia Repair in Our Hospital from 2013 to 2015

目的:分析未预防性应用抗菌药物的小儿腹股沟疝修补术术后发热及感染情况,供临床用药参考。方法:选取2013-2015年在郑州儿童医院行腹股沟疝修补手术围术期未预防用抗菌药物的患儿2 309例,根据手术前后腋下体温变化及手术部位感染情况分析是否需要应用抗菌药物。结果:2 309例患儿中,左侧腹股沟斜疝871例,右侧腹股沟斜疝1 306例,双侧腹股沟斜疝132例。单侧腹股沟斜疝患儿术后发热52例(2.39%),双侧腹股沟斜疝患儿术后发热8例(6.06%),均经物理降温或药物等对症处理后体温恢复正常。2013年、2014年、2015年手术部位感染率分别为0.13%(1/785)、0.13%(1/753)、0.26%(2/771),两两比较差异无统计学意义(P>0.05),均符合清洁手术切口感染率小于1%的规定。结论:术后发热是机体对手术创伤性炎症的正常反应,是由于手术组织损伤引起的非感染性发热,应避免盲目使用抗菌药物,只有术后切口感染的发热患儿才需要应用抗菌药物。

Objective：To investigate fever and infection in children after non-prophylactic use of antibiotics in pediatric inguinal hernia repair in our hospital.Methods：A retrospective study on non-prophylactic use of antibiotics was conducted in 2,309 children undergoing inguinal hernia repair during perioperative period from 2013 to 2015.Whether needed to use antibiotics were depended on axillary temperature and surgical site infection before and after the operation.Results：In 2,309 cases,there were 871 cases with left inguinal hernia,1,306 cases with right inguinal hernia and 132 cases with bilateral inguinal hernia.Fifty-two cases had a fever and accounted for 2.39% in children with unilateral inguinal hernia.Eight cases had a fever and accounted for 6.06% in children with bilateral inguinal hernia.The temperature of all the febrile children returned to normal by physical cooling or medication.The infection rates of the surgical site were 0.13%,0.13% and 0.26% respectively in 2013,2014 and 2015,which were in compliance with the clean surgical incision infection rate less than 1%.The infection rates of the surgical site were not significant different（P〉0.05）.Conclusion：Postoperative fever is the body＇s normal response to traumatic inflammation.It is non-infectious fever that caused by the tissue damage.Postoperative fever should avoid blindly use of antibiotics.Only postoperative incision infection children with fever need to use antiinfection treatment.