鼻腔手术填塞后合理使用抗生素的研究

The study of the rational use of antibiotics after nasal surgery

目的:研究鼻窦炎患者及非鼻窦炎患者鼻腔手术后是否应使用抗生素、如何使用抗生素,从而进一步指导鼻腔术后规范使用抗生素。方法:前瞻性分层随机对照研究,将手术患者分为鼻窦炎和非鼻窦炎两层,鼻窦炎组患者依据抗生素使用分为非抗生素使用组(A组)、标准抗生素使用组(B组)及延长抗生素使用组(C组);非鼻窦炎手术组患者随机分为非抗生素使用组(D组)、标准抗生素使用组(E组)及延长抗生素使用组(F组)。观察每组患者的术后感染率并分层比较。结果:鼻窦炎组内A、B、C组的感染率分别是3.53%、2.67%、0.00%,组间差异无统计学意义。非鼻窦炎组内D、E、F组的感染率分别为1.22%、0.00%、1.39%,组间差异无统计学意义。结论:鼻窦炎及非鼻窦炎患者鼻腔术后不使用或标准使用及延长使用抗生素对术后感染率无影响,推荐不使用抗生素,酌情按规范使用48h以内,不推荐延长使用。

Objective：To study whether the antibiotics should be used in the patients with or without chronic nasal sinusitis after the nasal surgery,and how to rationally use it.Method：Study design：prospective stratified randomized controlled study.Patients with sinusitis were divided into three groups.A group was without antibiotics,B group was with standard antibiotics using,and C group was with prolonged antibiotics using.Patients without sinusitis were divided into D group without antibiotics,E group with standard antibiotics using,and F group with prolonged antibiotics using.Observe the postoperative infection rate in each group and compare them.Result：The infection rates were 3.53%,2.67%,0.00%in A,B and C group,and there was no significant differences between three groups.The infection rates were 1.22%,0.00%,1.39%in D,E and F group,and there was no significant differences between them.Conclusion：There was no influence in patients with or without using antibiotics,standard or prolonged using antibiotics after nasal surgery.Recommend not to use antibiotics after nasal surgery,and appropriately use antibioctics within 48 hours.Prolonged using is not recommended.