妇科腹腔镜手术预防性使用抗生素的效果探析

Analysis of the effect of preventive use of antibiotics in gynecological laparoscopic surgery

目的探讨妇科腹腔镜手术预防性使用抗生素的效果。方法150例行妇科腹腔镜手术患者,依据抗生素方案的不同划分为观察组与对照组,每组75例。观察组在术前30 min预防性使用抗生素头孢呋辛,对照组于术前30 min及术后连续2 d静脉滴注头孢呋辛。比较两组患者手术指标、发热情况、最高体温、术后白细胞计数、术后感染情况、住院费用、抗生素费用。结果观察组患者术中出血量(24.45±10.26)ml、住院时间(8.92±2.31)d以及肠道恢复时间(17.45±4.12)h与对照组的(25.04±9.86)ml、(8.95±2.32)d、(17.42±3.06)h比较差异均无统计学意义(P>0.05)。观察组发热率2.67%、术后白细胞计数(6.35±1.83)×10^9/L与对照组的6.67%、(6.30±1.82)×10^9/L比较,差异无统计学意义(P>0.05)。观察组患者最高体温(37.12±0.15)℃低于对照组的(39.78±0.12)℃,差异具有统计学意义(P<0.05)。观察组患者术后感染率2.67%与对照组的1.33%比较,差异无统计学意义(P>0.05)。观察组住院费用(5172.12±320.25)元与抗生素费用(207.45±24.45)元明显低于对照组的(6227.47±401.26)、(674.38±33.24)元,差异均具有统计学意义(P<0.05)。结论妇科腹腔镜手术术前30 min使用抗生素可达到预防感染的效果,术后不必再继续使用抗生素,以减轻患者经济负担,值得临床应用。

Objective To discuss the effect of preventive use of antibiotics in gynecological laparoscopic surgery.Methods A total of 150 patients undergoing gynecological laparoscopic surgery were divided into observation group and control group according to different antibiotic regimens,with 75 cases in each group.The observation group was given the antibiotic cefuroxime prophylactically half an hour before the operation,and the control group was given intravenous cefuroxime 30 min before the operation and 2 d continuously after the operation.The operative indicators,fever,maximum body temperature,postoperative white blood cell count,postoperative infection,hospitalization expenses,and antibiotic expenses were compared between the two groups.Results The amount of intraoperative hemorrhage(24.45±10.26)ml,hospitalization time(8.92±2.31)d and recovery time of intestinal function(17.45±4.12)h of the observation group had no statistically significant difference compared with(25.04±9.86)ml,(8.95±2.32)d,(17.42±3.06)h of the control group(P>0.05).The fever rate 2.67%and postoperative white blood cell count(6.35±1.83)×10^9/L of the observation group had no statistically significant difference compared with 6.67%and(6.30±1.82)×10^9/L of the control group(P>0.05).The maximum body temperature(37.12±0.15)℃of the observation group was lower than(39.78±0.12)℃of the control group,and the difference was statistically significant(P<0.05).The postoperative infection rate 2.67%of the observation group had no statistically significant difference compared with 1.33%of the control group(P>0.05).The hospitalization expenses(5172.12±320.25)yuan and antibiotic expenses(207.45±24.45)yuan of the observation group were obviously lower than(6227.47±401.26)and(674.38±33.24)yuan of the control group,and the difference was statistically significant(P<0.05).Conclusion The use of antibiotics half an hour before gynecological laparoscopic surgery can prevent infection,and there is no need to continue to use antibiotics after surgery to reduce the economic burden of patients.It is worthy of clinical application.