腹腔镜子宫肌瘤切除术围手术期应用抗菌药物的情况回顾性分析

Retrospective analysis of the perioperative application of antibacterial drugs during laparoscopic myomectomy

目的对腹腔镜子宫肌瘤切除术围手术期应用抗菌药物的情况进行回顾性分析,并分析腹腔镜子宫肌瘤切除术围手术期感染的影响因素。方法选择2018年5月—2021年5月在我院行腹腔镜子宫肌瘤切除术的患者72例进行回顾性分析。收集患者一般资料及抗生素使用情况,根据有无术后感染将患者分为2组,比较2组患者上述各资料,并采用多因素分析法判断各因素对腹腔镜子宫肌瘤切除术后感染的综合作用。结果本次纳入的72例腹腔镜子宫肌瘤切除术患者共有16例出现术后感染,术后感染率为22.22%。多因素Logistic回归分析结果显示:年龄≥50岁、手术时间≥60 min、合并糖尿病为腹腔镜子宫肌瘤切除术围手术期感染的危险因素,预防性使用抗生素、术前≤2 h抗生素使用、术后抗生素使用≤48 h为保护性因素(P<0.05)。结论腔镜子宫肌瘤切除术患者术后感染率为22.22%,抗菌药物使用时机及使用时间对腹腔镜子宫肌瘤切除术患者术后感染有重要的影响,此外患者年龄、手术时间、合并糖尿病情况也与患者术后感染有关。

Objective To retrospectively analyze the perioperative application of antibacterial drugs during laparoscopic myomectomy,and to analyze the influencing factors of infection during the perioperative period of laparoscopic myomectomy.Methods Seventy-two patients who underwent laparoscopic myomectomy in our hospital from May 2018 to May 2021 were selected for retrospective analysis.The patients were divided into two groups according to postoperative infection status.The above data were compared between the two groups,and the comprehensive effects of various factors on postoperative infection after laparoscopic myomectomy were determined by multivariate analysis.Results There were 16 cases of 72 patients underwent laparoscopic myomectomy had postoperative infection,and the postoperative infection rate was 22.22%.Multivariate Logistic regression analysis showed that age over 50,operation time over 60 minutes,and with diabetes mellitus were the risk factors of perioperative infection in laparoscopic myomectomy.Prophylactic use of antibiotics,preoperative use of antibiotics in less than 2 hours and postoperative use of antibiotics in less than 48 hours were protective factors(P<0.05).Conclusions The infection rate of patients underwent laparoscopic myomectomy was 22.22%.The time and length of antibiotics use had important influence on postoperative infection of patients underwent laparoscopic myomectomy.In addition,age,operation time and complicated with diabetes mellitus were also related to postoperative infection.