声带息肉切除手术疗效与围术期预防使用抗菌药物关系分析

Analysis of the relationship between vocal fold polypectomy and perioperative prophylactic use of antibiotics

目的探讨声带息肉切除手术疗效与围术期预防使用抗菌药物的关系。方法回顾性选取广州市第十二人民医院2016年1月至2017年12月收治的行声带息肉切除手术患者资料121例,统计患者围术期预防使用抗菌药物情况,按围术期抗菌药物使用时间不同进行分组,比较各组患者术前术后体温、白细胞计数及嗓音基频微扰、振幅微扰、嗓音障碍严重指数(DSI)等嗓音声学参数,观察其术后声带创面及声门闭合情况。结果 4组患者手术前后白细胞计数、体温比较,差异均无统计学意义(均P>0.05)。术后4组患者的3项嗓音参数与术前比较均显著改善(均P<0.05),但组间比较差异均无统计学意义(均P>0.05)。动态喉镜检查提示各组患者术后均无创面感染情况发生,创面愈合良好。结论声带息肉手术可不使用抗菌药物预防感染,当存在可能导致切口感染情况时,预防用药时间不宜超过24 h。

Objective To investigate the effect of vocal cord polypectomy and perioperative antibiotic prophylaxis. Methods A retrospective study of 121 cases of vocal cord polyp resection in Guangzhou twelfth people＇s Hospital from January 2016 to December 2017 was conducted to compare the perioperative use of antibiotics to prevent the use of antibiotics in perioperative period. The body temperature, white blood cell count and voice base were compared in each group. Acoustic parameters such as frequency perturbation,amplitude perturbation and voice disturbance severity index were used to observe the postoperative vocal fold wound and glottis closure.Results There was no significant difference in white blood cell count and body temperature between the 4 groups before and after operation（P〉0.05）. After the operation,the 3 voice parameters of the 4 groups were significantly improved compared with those before operation（P〈0.05）, but there was no statistically significant difference between the two groups（P〈0.05）. Dynamic laryngoscopy showed no wound infection in all groups after operation, and the wound healed well. Conclusion The vocal cord polyp surgery may not use antibacterial drugs to prevent infection,it can accomplish the infection prevention within 24 hours after surgery if there are incision infection factors.