CAJ | 학술논문

目的：分析腹腔镜术后抗感染情况,探讨术后感染的有效防治措施.方法选取腹腔镜手术患者341例作为研究对象,腹腔镜子宫全切和次全切手术( A组)172例(污染类手术)；腹腔镜下卵巢囊肿剥出术( B组)169例(清洁类手术),再依照术后预防性使用抗菌药物1,3,7 d和未使用抗菌药物分为Ⅰ~Ⅳ4个亚组,对比患者手术时间、术后退热时间、抗菌药物使用时间和术后感染发生率情况.结果 A组和B组手术时间、术后体温和肠功能恢复时间各亚组间差异均无统计学意义(P>0.05)；A组中使用抗菌药物的AⅠ~ AⅢ3个亚组中AⅠ组抗菌药物平均使用时间明显短于AⅡ,AⅢ组,差异具有显著统计学意义(P<0.01)；AⅣ亚组术后退热时间明显长于AⅠ~ AⅢ亚组,术后感染率明显高于AⅠ~ AⅢ亚组,差异均具有统计学意义(P<0.05)；BⅠ~ BⅣ4个亚组之间手术时间差异无统计学意义(P>0.05)；BⅣ亚组术后退热时间和术后感染率与BⅠ~ BⅢ亚组相比差异均无统计学意义(P>0.05).结论妇科腹腔镜手术中,对于清洁类手术患者术后不必给予抗菌药物,污染类手术延长术后抗菌药物给药时间与感染发生率之间无明显相关性,应根据患者实际情况尽量缩短给药时间.
목적：분석복강경술후항감염정황,탐토술후감염적유효방치조시.방법선취복강경수술환자341례작위연구대상,복강경자궁전절화차전절수술( A조)172례(오염류수술)；복강경하란소낭종박출술( B조)169례(청길류수술),재의조술후예방성사용항균약물1,3,7 d화미사용항균약물분위Ⅰ~Ⅳ4개아조,대비환자수술시간、술후퇴열시간、항균약물사용시간화술후감염발생솔정황.결과 A조화B조수술시간、술후체온화장공능회복시간각아조간차이균무통계학의의(P>0.05)；A조중사용항균약물적AⅠ~ AⅢ3개아조중AⅠ조항균약물평균사용시간명현단우AⅡ,AⅢ조,차이구유현저통계학의의(P<0.01)；AⅣ아조술후퇴열시간명현장우AⅠ~ AⅢ아조,술후감염솔명현고우AⅠ~ AⅢ아조,차이균구유통계학의의(P<0.05)；BⅠ~ BⅣ4개아조지간수술시간차이무통계학의의(P>0.05)；BⅣ아조술후퇴열시간화술후감염솔여BⅠ~ BⅢ아조상비차이균무통계학의의(P>0.05).결론부과복강경수술중,대우청길류수술환자술후불필급여항균약물,오염류수술연장술후항균약물급약시간여감염발생솔지간무명현상관성,응근거환자실제정황진량축단급약시간.
Objective To analyze the situation of anti-infection after laparoscopic surgery and to explore effective prevention measures for postoperative infection. Method A total of 341 patients underwent laparoscopic gynecologic surgery were enrolled as the research object. The patients were divided into two groups according to the pollution type of the surgery. Group A included 172 cases of laparoscopic hysterectomy and subtotal resection ( contaminated surgery) ,and group B contained 169 cases of laparoscopic ovarian cystectomy ( clean surgery) . Then,each group were divided into four sub groupⅠ~Ⅳin accordance with the postoperative prophylactic use of antimicrobial agents (1,3,7 d and no use). The operation time,postoperative fever time, usage time of antibiotics and the incidence of postoperative infection were compared. Results There were no significant differences in the operation time, postoperative recovery time of body temperature and intestinal function among all the groups ( P>0 . 05 ) . The usage time of antibacterial agents in group AⅠwas much shorter than in group AⅡ and AⅢ ( P<0 . 01 );The postoperative fever time in group AⅣ was significantly longer than in the other three sub-groups,and the postoperative infection rate in group AⅣwas much higher too (P<0. 05). Compared with group BⅠ ~ BⅢ, the operation time, postoperative fever time and infection rate showed no significant differences in group BⅣ(P>0. 05). Conclusion In laparoscopic surgery,it is not necessary to give patients antibiotics after clean operation,and there is no obvious correlation between the medication time and the <br> rate of infection post contaminated operation. The administration time should be as short as possible based on the actual situation of the patients.