抗菌药物不同给药方式对妇科经阴道手术术后切口感染的预防效果及药物经济学分析

The Preventive Effect and Pharmacoeconomic Analysis of Different Administration Methods of Antibiotics on Incision Infection after Gynecological Trans vaginal Surgery

目的 探讨抗菌药物不同给药方式对妇科经阴道手术术后感染的预防效果及药物经济学分析。方法 选择某院2020年10月~2021年10月收治的妇科经阴道手术患者79例,使用随机数字表法将其分为对照组(39例)和观察组(40例),观察组术后给予头孢美唑预防感染,对照组给予头孢呋辛联合替硝唑,比较两组治疗后的临床疗效,两组患者术前及术后的血清C反应蛋白(CRP)、降钙素原(PCT)、白细胞计数(WBC),两组术前及术后体温、两组术后住院时间及感染情况,同时比较两组用药期间不良反应发生情况及抗菌药物费用情况。结果 对照组治疗总有效率、治疗后的PCT、CRP及WBC水平、体温、住院时间及切口感染例数与观察组比较差异无统计学意义(P>0.05)。对照组不良反应发生率高于观察组,对照组用药费用及单位疗效用药费用高于观察组,差异有统计学意义(P<0.05)。结论 头孢呋辛联合替硝唑与单用头孢美唑比较,在妇科经阴道手术后切口感染预防方面效果相当,两种用药方式治疗总有效率、患者住院时间、切口感染例数、实验室指标、体温指标等均相当,但联合用药增加了患者的不良反应发生率及用药费用,考虑单一用药更符合临床合理用药规范。

OBJECTIVE To investigate the preventive effect and pharmacoeconomic analysis of different administration methods of antibiotics on infection after gynecological trans vaginal surgery.METHODS A total of 79 patients with gynecological trans vaginal surgery who were admitted to a hospital from October 2020 to October 2021 were selected and divided into the control group(39 cases)and the observation group(40 cases)using the random number table method.Cefmetazole was given to prevent infection in the observation group,and the control group was given cefuroxime combined with tinidazole.The clinical efficacy of the two groups after treatment were compared.C-reactive protein(CRP),procalcitonin(PCT),white blood cell count(WBC),preoperative and postoperative body temperature,postoperative hospital stay and infection in the two groups,and the incidence of adverse reactions and the cost of antibiotics during the two groups were compared.RESULTS There were no significant difference in the total effective rate of treatment,PCT,CRP and WBC levels,body temperature,hospital stay and the number of wound infections between the control group and the observation group after treatment(P>0.05).The incidence of adverse reactions in the control group was higher than that in the observation group,and the drug costs and unit efficacy drug costs in the control group were higher than those in the observation group,and the difference was statistically significant(P<0.05).CONCLUSION Cefuroxime combined with tinidazole is comparable to cefmetazole alone in preventing incision infection after gynecological trans vaginal surgery.The total effective rate,hospitalization time,number of incision infections and laboratory indicators of the two methods of treatment,body temperature and other indicators are equivalent,but the combination of medication increases the incidence of adverse reactions and medication costs of patients.So a single medication is more in line with the clinical rational drug use norms.