规范化与长期应用抗生素预防术后伤口感染的效果对比

Comparison between Standard and Long-term Application of Antibiotics for Surgical Site Infection in Orthopedic Surgery

目的 探讨不同方法预防性应用抗生素在骨科手术中的预防感染效果。方法 回顾性分析 1997～ 2 0 0 0年不同骨科择期手术患者 ,按抗生素预防性应用的方法分为两组 :A组为规范性应用抗生素组 ,原则为一般情况下不应用抗生素 ,但手术中放入较多内植物等大手术时 ,则于麻醉后手术前应用 1次 ,术后应用不超过 3 6h,共计92 1人 ;B组为长期大剂量应用抗生素组 ,除按 A组的方法应用外 ,术前 1d可能应用抗生素 ,术后应用 3 6h以上或直至患者体温降至 3 7.5℃以下 ,共计 12 13人 ;对比两组患者的伤口感染率。结果 两组患者伤口感染分别为5例和 8例 ,两组间感染率差异无统计学意义。

OBJECTIVE To compare the anti infection results between standard and long term application of antibiotics in orthopedic surgery. METHODS To retrospectively analyze the infection results of selected patients in orthopedic surgery between the years of 1997 and 2000. According to the application way of antibiotics, the patients were divided into 2 groups. In group A, antibiotics were usually not applied. If the operation is too complicated or there would be too many implants were used in the patients′ body, antibiotics would be applied intravenously within 30 min before the operation, the postoperative application of antibiotics were never beyond 36 hours. There were 921 patients in group A. In group B, except the application of antibiotics during the operation, a dose of antibiotics mightbe or might not be used one day before the surgery, and the postoperative application lasted for, at least, over 36 hours, or till the patients′ body temperature was under 37.5℃. There were 1 213 patients in this group. RESULTS There were 5(0.54%) and 8(0.66%) surgical site infection (SSI) cases in groups A and B, respectively, the infection rates were not statistically different between them.CONCLUSIONS The perioperative long term application of antibiotics can not further reduce the wound infection rate comparing with standard application of antibiotics.