CAJ | 학술논문

目的探讨围手术期预防性使用抗生素对神经外科术后手术部位感染的影响.方法抽调2011年9月1日至23日期间和2010年同期于首都医科大学附属天坛医院神经外科接受清洁手术的所有患者的病例资料,共679例.统计术后手术部位感染(SSI)的发生率,并进行危险因素分析.结果在2011年限制预防性使用抗生素期间(预防性使用抗生素比例为36.6％),术后SSI发生率为16.5％,明显高于2010年同期的5.0％水平(预防性使用抗生素比例为80.7％).预防使用抗生素是降低术后SSI发生率的独立因素(OR值为0.30,P＜0.001).预防性使用抗生素可以降低65.0％的术后SSI发生率(P＜0.01),特别是术后切口感染的发生率,可降低81％ (P＜0.01),可以缩短中位住院时间达2d,减少了7％的中位住院费用.结论神经外科围手术期预防性使用抗生素可以大大降低术后SSI的发生,是术后SSI的独立保护因素,能明显降低住院时间和住院费用,具有较好的卫生经济学效应.
목적 탐토위수술기예방성사용항생소대신경외과술후수술부위감염적영향.방법 추조2011년9월1일지23일기간화2010년동기우수도의과대학부속천단의원신경외과접수청길수술적소유환자적병례자료,공679례.통계술후수술부위감염(SSI)적발생솔,병진행위험인소분석.결과 재2011년한제예방성사용항생소기간(예방성사용항생소비례위36.6％),술후SSI발생솔위16.5％,명현고우2010년동기적5.0％수평(예방성사용항생소비례위80.7％).예방사용항생소시강저술후SSI발생솔적독립인소(OR치위0.30,P＜0.001).예방성사용항생소가이강저65.0％적술후SSI발생솔(P＜0.01),특별시술후절구감염적발생솔,가강저81％ (P＜0.01),가이축단중위주원시간체2d,감소료7％적중위주원비용.결론 신경외과위수술기예방성사용항생소가이대대강저술후SSI적발생,시술후SSI적독립보호인소,능명현강저주원시간화주원비용,구유교호적위생경제학효응.
Objective To investigate the effect of perioperative prophylactic administration of antibiotics on post-neurosurgical infection incidence.Methods It was a retrospective design by using 679 cases of patients who underwent clean neurosurgical operations at Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University during Sep 1 st to Sep 23 rd in 2011 and the same period in 2010.The incidence of Surgical Site Infection (SSI) were calculated and compared between the two periods.Univariate analysis and logistic regression analysis were applied to reveal SSI-related risk factors.Results The SSI incidence was significantly higher during Sep 1st to Sep 23 rd in 2011 than the same period in 2010 (16.5％ to 5.0％,P ＜ 0.01).And the proportion of prophylactic antibiotic administration was significantly lower during the period in 2011 than in 2010 (36.6％ to 80.7％,P ＜0.01).Prophylactic administration of antibiotics was an independent factor that significantly reduced the SSI incidence (odds ratio,0.30;P ＜0.001).Prophylactic administration of antibiotics significantly reduced the SSI incidence by 65.0％ (P ＜0.01) and the cut infection incidence by 81％ (P ＜0.01).In terms of health economics,prophylactic administration of antibiotics shortened median hospital stays by 2 days and decreased median hospitalization cost by 7％.Conclusions Perioperative prophylactic administration of antibiotics can reduce post-neurosurgical SSI incidence significantly and independently,and then shorten median hospital stays and decrease median hospitalization cost.