【摘要】 目的分析围术期短程抗菌药物预防阴式子宫切除术加网片盆底重建术术后感染的效果。方法选取嘉兴市妇幼保健院2014年1~12月行阴式子宫切除术加网片盆底重建术的55例患者作为对照组,采取长程抗菌药物预防策略(>48 h);2015年1~12月行阴式子宫切除术加网片盆底重建术的63例患者作为研究组,采取短程抗菌药物预防策略(≤48 h)。比较两组围术期预防使用的抗菌药物使用率、抗菌药物费用、住院总费用及手术部位感染率、尿路感染率、发热情况。结果研究组与对照组的围术期预防使用的抗菌药物使用率均为100%,研究组手术部位感染率、尿路感染率、发热率分别为3.2%、6.3%、3.1%,对照组分别为1.8%、9.1%、1.8%,差异无统计学意义(P>0.05);研究组的平均住院时间、抗菌药物使用时间、抗菌药物费用与住院总费用分别为(9.8±2.0)d、(48.1±3.2)h、(527.0±170.6)元和(17 342.1±3349.7)元,均低于对照组的(12.7±2.2)d,(95.8±6.1)h,(770.4±187.1)元和(18 719.7±3170.2)元,差异均有统计学意义(P<0.05)。结论对于需行阴式子宫切除术加网片盆底重建术的患者,实施短程围术期抗菌药物预防策略的优势更加明显,不仅能与长程预防策略的临床疗效相似,而且能明显降低抗菌药物费用和住院费用。更多还原

【Abstract】 Objective To analyze the effect of perioperative short-term prophylactic antibiotics on the prevention of surgical infections in vaginal hysterectomy and mesh pelvic floor reconstruction.Methods Fifty-five cases with pelvic floor reconstruction after vaginal implantation from January to December in 2014 were selected as the control group,and were given long-term(longer than 48 h) antibacterial drug prevention.Meanwhile,63 cases from January to December in 2015 were taken as the research group and proviced the short-term antibacterial drug prevention strategy(shorter than 48 h).The utilization rate of antibiotics,the cost of antibiotics and hospitalization,the infection rate of surgical site,as well as the incidence of urinary tract infection and fever were compared between the two groups in perioperative period.Results The average stay,use time of antibiotics,the total cost of antibiotics and inpatients expenses in the research group [(9.8±2.0) d,(48.1±3.2) h,(527.0±170.6) yuan and(17 342.1±3349.7) yuan] were lower than those of the control group [(12.7 ±2.2) d,(95.8 ±6.1) h,(770.4 ±187.1) yuan,(18 719.7 ±3170.2) yuan],the differences were statistically significant(P<0.05).Conclusion For patients who need to be treated by vaginal hysterectomy and mesh pelvic floor reconstruction,the implementation of short-term perioperative antimicrobial drug prevention strategy has more prominent clinical benefits not only on similar clinical efficacy but also on reduced expense of antibiotics and hospitalization.更多还原