CAJ | 학술논문

目的探讨腹股沟无张力疝手术后是否需要使用抗生素.方法按照随机双盲法,前瞻性的研究分析2007年3月至2008年3月陕西省人民医院普通外科收治的180例腹股沟疝无张力疝修补手术后患者.两组术前30 min均给予二代头孢菌素1.5 g,术后试验组连用3 d,而对照组仅给予生理盐水输注.术后16例患者无法联系随访,入组率为91.11%.进入符合方案集(PP)分析者164例,其中试验组84例,对照组80例.结果 164例患者中共有3例发生手术部位感染(1.83%),其中试验组有1例发生皮下感染,1例发生深部感染,对照组1例发生皮下感染,两组手术部位的感染经统计学分析,差异无统计学意义.随访时间12～29个月,平均随访时间试验组为(15.6±2.2)个月,对照组(18±3)个月.试验组的随访例数为84例,随访率为93.33%;对照组的随访例数为80例,随访率为88.89%,随访期间试验组和对照组没有疝复发病例,没有观察到使用抗生素产生的副作用.结论为了预防手术部位感染,对于腹股沟无张力疝手术需术前一次性使用抗生素,手术后继续使用抗生素是不必要的.
목적 탐토복고구무장력산수술후시부수요사용항생소.방법 안조수궤쌍맹법,전첨성적연구분석2007년3월지2008년3월합서성인민의원보통외과수치적180례복고구산무장력산수보수술후환자.량조술전30 min균급여이대두포균소1.5 g,술후시험조련용3 d,이대조조부급여생리염수수주.술후16례환자무법련계수방,입조솔위91.11%.진입부합방안집(PP)분석자164례,기중시험조84례,대조조80례.결과 164례환자중공유3례발생수술부위감염(1.83%),기중시험조유1례발생피하감염,1례발생심부감염,대조조1례발생피하감염,량조수술부위적감염경통계학분석,차이무통계학의의.수방시간12～29개월,평균수방시간시험조위(15.6±2.2)개월,대조조(18±3)개월.시험조적수방례수위84례,수방솔위93.33%;대조조적수방례수위80례,수방솔위88.89%,수방기간시험조화대조조몰유산복발병례,몰유관찰도사용항생소산생적부작용.결론 위료예방수술부위감염,대우복고구무장력산수술수술전일차성사용항생소,수술후계속사용항생소시불필요적.
Objective To evaluate the efficacy of perioperative antibiotic prophylaxis for tension-free repair of inguinal hernia. Methods A randomized, prospective double-blind control trial was performed to evaluate the efficacy of perioperative antibiotic prophylaxis for tension-free mesh repair in 180 cases of inguinal hernia from March 2007 to March 2008. Intravenous cefuroxime ( 1.5 g ) was given immediately before the surgery in two groups followed by postoperative administration of cefuroxime 1.5 g twice a day for 3 days in test group compared with NS infusion in the control group. Postoperatively 16 patients (8. 89 per cent) could not be contacted at any point, giving a response rate of91. 11%. The total number of subjects for per- protocol (PP) analysis was 180, 84 cases in test group and 80 cases in control group. Results Complete data were available for 164 patients, 3 ( 1.83 per cent) developed surgical site infection (SSI) including 2 cases of surgical site infection in test group and 1 case of superficial incision surgical site infection in control group. The differences were not statistically significant. The time to follow up was 12 -29 months, the mean follow up time in test group was (15.6 ±2.2) months and (18 ±3)months in control group respectively. 93.33% patients in test group were followed up and 88. 89% patients in control group. There were not hernia recurrence and side effect of antibiotics reported in the two groups.Conclusions To prevent SSI, it is necessary to use preoperative antibiotics prophylaxis just one time for inguinal hernia repair.