预防性使用抗菌药对骨科手术围手术期SSI的疗效分析及对TNF-α、IL-6、hs-CRP水平的影响

Curative Effect of Preventive Use of Antibacterial Agents on Perioperative Surgical Site Infection in Orthopedic Surgery and Influence on TNF-α, IL-6 and hs-CRP Levels

目的 :探讨预防性使用抗菌药对骨科手术围手术期手术部位感染(SSI)及对肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6和超敏C反应蛋白(hs-CRP)的影响。方法:选取2016年2月-2017年3月在我院骨科手术治疗的患者216例,根据术后干预方法分为观察组(107例)和对照组(109例),观察组给予预防性抗菌药,对照组给予常规干预方法,观察两组围手术期SSI发生情况以及住院时间和费用,同时检测患者TNF-α、IL-6、hs-CRP水平。结果:观察组围手术期SSI发生率为1.87%,明显低于对照组(P<0.05);观察组术后3 d和7 d血清中TNF-α、IL-6和hs-CRP分别为(41.26±6.07)pg/m L、(30.21±4.43)pg/m L、(31.06±5.21)pg/m L与(22.54±6.11)pg/m L、(5.60±1.16)pg/m L、(2.44±0.96)pg/m L,明显低于对照组(P<0.05);观察组住院时间和住院费用分别为(9.84±1.80)d和(9 766.53±502.13)元,明显低于对照组(P<0.05)。结论 :预防性使用抗菌药可降低骨科手术围手术期SSI的发生,降低患者炎性因子水平,同时可降低患者住院时间和费用。

Objective:To investigate the effects of preventive use of antibacterial agents on perioperative surguical site infection in orthopedic surgery and TNF-α,IL-6 and hs-CRP levels.Methods:A total of 216 patients receiving orthopedic surgery in Hospital of Orthopedics of Zhengzhou City,Henan Province from February 2016 to March 2017 were divided into trial(n=107)and control(n=109)groups,and treated with antibacterial agents and routine intervention respectively.The incidence of SSI in perioperative period as well as time and cost for hospitalization in the two groups were observed,and the TNF-α,IL-6 and hsCRP levels of patients were determined.Results:The incidence of SSI in perioperative period in trial group was 1.87%,which was significantly lower than that in control group(P<0.05).The TNF-α,IL-6 and hs-CRP levels in trial group were(41.26±6.07)pg/m L,(30.21±4.43)pg/m L and(31.06±5.21)pg/m L 3 d,and(22.54±6.11)pg/m L,(5.60±1.16)pg/m L and(2.44±0.96)pg/m L 7 d after surgery,respectively,which were significantly lower than those in control group(P<0.05).The mean time for hospitalization in trial group were(9.84±1.80)d,which was significantly shorter than that in control group(P<0.05).However,the mean cost for hospitalization in trial group was RMB(9 766.53±502.13),which was significantly less than that in control group(P<0.05).Conclusion:Prophylactic use of antibacterial agents decreased the incidence of SSI in perioperative period of orthopedic surgery,the inflammatory factor level of patients as well as the time and cost for hospitalization.