胆囊微创手术患者胆囊破裂后抗菌药物应用对手术部位感染影响的研究

Effects of Antimicrobial Agents on Surgical Site Infection in Patients with Gallbladder Rupture after Minimally Invasive Surgery

目的探讨胆囊微创手术患者在胆囊破裂后应用抗菌药物对患者手术部位感染的影响。方法选取本院胆囊微创手术患者80例,选取时间为2016年7月至2018年8月,按随机数表法分成对照组和观察组,各40例患者,对照组不接受任何抗菌药物治疗,观察组则接受抗菌药物治疗,比较两组患者的手术时间、住院时间、粘连部位分布情况、中性粒细胞和血白细胞。结果观察组患者的手术时间为(54.81±4.61)min、住院时间为(5.14±0.34)d,对照组患者的手术时间为(54.29±4.36)min、住院时间为(5.64±0.48)d,二者无差异,P>0.05。观察组患者中,胆囊三角粘连者14例(35%),胆囊与周边粘连者13例(32.5%);对照组患者中,胆囊三角粘连者18例(40.91%),胆囊与周边粘连者16例(40%);二者无差异,P>0.05。观察组患者的术后中性粒细胞为(72.61±14.32),术后血白细胞为(9.14±1.24);对照组患者的术后中性粒细胞为(82.54±15.64),术后血白细胞为(12.39±4.25);观察组低于对照组,P<0.05。结论在胆囊微创手术中,若患者出现胆囊破裂现象,应依据患者的具体情况酌情选择是否使用抗菌药物,若患者的危险因素较低则不必采用抗菌药物。

Objective To investigate the effect of antimicrobial agents on surgical site infection in patients with gallbladder rupture after minimally invasive surgery.Methods Eighty patients with minimally invasive surgery of the gallbladder in our hospital were selected.The time was from July 2016 to August 2018.The patients were divided into the control group and the observation group according to the random number table method.Each group of 40 patients did not receive any antibiotic treatment.The observation group received antibiotic treatment,and the operation time,hospitalization time,adhesion site distribution,neutrophils and white blood cells were compared between the two groups.Results The operation time of the observation group was(54.81±4.61)and the hospitalization time was(5.14±0.34).The operation time of the control group was(54.29±4.36)and the hospitalization time was(5.64±0.48).There was no difference between the two groups.P>0.05.Among the observation group,14 cases(35%)had gallbladder triangle adhesion,13 cases(32.5%)had gallbladder and peripheral adhesions;18 cases(40.91%)had gallbladder triangle adhesion,gallbladder and peripheral adhesions among the control group.Example(40%);there was no difference between the two,P>0.05.The postoperative neutrophils were(72.61±14.32)in the observation group and(9.14±1.24)in the postoperative white blood cells.The postoperative neutrophils were(82.54±15.64)in the control group(12.39±4.25);the observation group was lower than the control group,P<0.05.Conclusion In minimally invasive gallbladder surgery,if gallbladder rupture occurs in the patient,the use of antimicrobial agents should be selected according to the specific situation of the patient.If the risk factors of the patient are low,the use of antimicrobial agents is not necessary.