老年患者腹股沟无张力疝修补术预防性应用抗生素合理性研究.doc

老年腹股沟疝无张力修补术预防性应用抗生素合理性研究 许志扬 江国英△ 陈国度 吴雨田 陈广泽 蔡智锋 林仁芳 （福建医科大学莆田市第一医院教学医院普外科，351100） 【摘要】 目的 探讨老年患者腹股沟疝无张力修补术是否需要常规预防性应用抗生素。方法 按照随机对照的原则对2009年5月至2012年12月我院诊治624例老年腹股沟疝进行前瞻性研究分析。治疗组312例，术前一次性应用预防性抗生素；对照组312例，术前未应用抗生素；对比两组术后手术部位感染发生率情况。结果 624例中共10例发生手术部位感染，其中治疗组2例，对照组8例，两组比较差异有显著性意义。比较两组术后第三天血白细胞计数、中性粒细胞比值差异有统计学意义。 结论 老年患者腹股沟疝无张力修补术建议常规应用抗生素预防术后手术部位感染。 关键词 老年， 腹股沟疝， 抗生素 Prophylactic antibiotics treatment for older tension-free repair of inguinal hernia . Xu Zhiyang ,Jiang Guoying , Chen Guodu ,Wu Yutian, Chen Guangze ,Cai Zhifeng ,Lin Renfang Fujian Med Universicity,Teaching Hospital,Hospital Putian 1,Department of general surgery △通信作者 Tel E-mail:jguoying@163.com Abstract objective To investigate the feasibility of tension-free repair of older inguinal hernia with prophylactic antibiotics treatment . Methods According to the principle of randomized controlled trial ，a total of 624 cases of older inguinal hernia treated from May 2009 to December 2012 in our hospital were analyzed prospectively . The cases were divided into two groups (control group and trial group ) . Cases in trial group (n=312) were treated by antibiotic once preoperatively while cases in control group (n=312) received no antibiotics treatment .The outcomes of surigical site infection rates between two groups were compared. Results Among 624 cases , 10 case (2 from trial group and 8 from control group ) developed surigal site infection . The difference was significant statiscally . There was significant difference in the results of complete white blood cell count , neutrophilic granulocyte ratio . Conclusion There is need to apply regular prophylactic antibiotics treatment for older tension-free repair of inguinal hernia . Keywords: older ; inguinal hernia ; antibiotics 本文对我院自2009年5月至2012年12月收治的624例70岁以上老年腹股沟疝进行前瞻性随机对照研究，探讨老年患者腹股沟疝无张力修补术是否需要常规预防性应用抗生素,报告如下。 1 资料