开腹根治性全胃切除术后抗生素使用时长对患者手术部位感染的影响

摘要

目的 探讨胃癌开腹根治性全胃切除术后抗生素不同使用时长对患者切口感染的影响.方法 回顾性分析207例行开腹根治性全胃切除术的胃癌患者资料,其中包括60例术后未使用抗生素(对照组)、72例术后预防性应用24 h抗生素(24 h预防组),75例术后预防性应用48 h抗生素(48 h预防组).分别比较术后第5天各组患者手术部位感染率,白细胞(WBC)计数、C-反应蛋白(CRP)水平和体温变化情况.结果 术后3组切口感染率差异无统计学意义(χ2＝1.707,P＝0.426);3组深部感染发生率差异有统计学意义(χ2＝10.653,P＝0.005).与对照组相比,24 h预防组、48 h预防组患者WBC计数、CRP水平、体温值均显著降低,差异具有统计学意义(P＜0.01).结论 胃癌开腹根治性全胃切除术中使用抗生素能有效降低术后深部感染阳性率,但对切口感染发生率没有明显影响.%Objective To investigate effects of different duration of antimicrobial prophylaxis for surgical-site infection(SSI)in patients undergoing open total gastrectomy(OTG)for gastric cancer.Methods 207 gastric cancer patients undergoing OTG were analyzed retrospectively,including 60 cases without antimicrobial prophylaxis(control group),72 cases with 24 h antimicrobial prophylaxis(24 h group)and 75 cases with 48 h antimicrobial prophylaxis (48 h group).The positive rate of SSI,levels of white blood cell count(WBC),C-reactive protein(CRP)and human body temperature(TEMP)of the three groups were compared on the fifth day after surgery.Results There was no sig-nificant difference on the rate of incision infection among the three groups(χ2＝1.707,P＝0.426).There was signifi-cant difference on the rate of deep infection among the three groups(χ2＝10.653,P＝0.005).The levels of WBC, CRP and TEMP decreased significantly in the 24 h group and 48 h group than those in the control group(P＜0.01). Conclusion Antimicrobial prophylaxis after OTG can prevent deep infection,however it might be not beneficial for incision infection.