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目的探讨监测骨科患者围手术期抗菌药物的使用对手术部位感染的影响。方法对实施手术的患者采用前瞻性监测方法,监测围手术期抗菌药物使用的种类、方法、用药时间、手术部位感染与临床治疗效果等,将所有调查资料进行归纳整理,进行统计分析,作出诊断性结论。结果监测骨科手术382例,46例未使用抗菌药物,336例使用抗菌药物,使用率87.96%;7例手术部位感染分泌物中分别检出表皮葡萄球菌3株、金黄色葡萄球菌4株、铜绿假单胞菌1株、阴沟肠杆菌2株。Ⅲ、Ⅳ类切口感染率高于Ⅰ、Ⅱ类切口,急诊手术感染率高于非急诊手术,开放切口感染率高于闭合切口,手术前0.5~2.0h使用抗生素感染率低于手术后使用抗生素,差异有统计学意义(P<0.01);手术时间≥3h与<3h比较差异无统计学意义(P>0.05)。结论围手术期使用抗菌药物,可有效降低骨科手术部位感染的发生。
Objective To investigate the effect of perioperative antibiotics on surgical site infection in orthopedic patients. Methods The patients undergoing surgery were prospectively monitored, and the types, methods, medication durations, surgical site infections and clinical effects of perioperative antibiotics were monitored. All the survey data were summarized and analyzed statistically to make a diagnosis Sexual conclusion. Results 382 cases of orthopedic surgery were monitored, 46 cases did not use antimicrobial agents, 336 cases were treated with antimicrobial agents, the rate was 87.96%. Staphylococcus epidermidis 3, Staphylococcus aureus 4, 1 strain of Pseudomonas and 2 strains of Enterobacter cloacae. The infection rates of type Ⅲ and type Ⅳ incision were higher than those of type Ⅰ and type Ⅱ incision. The infection rate of emergency operation was higher than that of non-emergency operation. The infection rate of open incision was higher than that of closed incision. The infection rate of antibiotics 0.5 ~ 2.0h before operation was lower than that of antibiotics , The difference was statistically significant (P <0.01); operation time ≥ 3h and <3h compared with no significant difference (P> 0.05). Conclusion Perioperative use of antimicrobial agents can reduce the incidence of infection in orthopedic surgery.