择期腹腔镜胆囊切除术应用抗生素的随机对照研究.docVIP

择期腹腔镜胆囊切除术应用抗生素的随机对照研究 刘志宁 周连帮 蒋恒 耿小平 俟辉 万圣云 喻宗繁 摘 要 目的 探讨择期腹腔镜胆囊切除术应用抗生素在围手术期意义。 方法 选取了 2012年4至2015.05月我院住院部收治性择期腹腔镜胆囊切除术 患者620例患者为研究对象，并随机分成两组，A组(n=308)麻醉诱导后静脉 滴注头也替安2.0g,术后同剂量连用2天，B组(312)则不使用任何抗生素。 然后对二组患者术后感染及并发症情况进行观察统计。结果620例患者均常规 完成手术，其中有15例发生外科感染，A组有6例(1.9%), B组有9例(2.8%), 两组差异无统计学意义(pgt;0.05)o两组的术后住院时间均在术后2-3天出院， 术后住院时间差异无统计学意义(Pgt;0.05);但两组的住院总费用相比差异有 统计学意义(Plt;0.05)结论 择期腹腔镜胆囊切除术围手术期不使用抗牛素并 未增加感染率，是安全可行的。 关键词 择期腹腔镜胆囊切除术； 抗牛素； 感染 The ran domized con trolled study of an tibiotics in elective laparoscopic cholecystectomy. Liu Zhi-ning, Zhou Lian?bangjiang heng,Geng Xiao-ping,Hou hui,Wa n She ng?yun,Yu zon g-fan. Departme nt of Ge neral Surgery, Second Hospital of Anhui Medical University, Hefei, Anhui230601, China [Abstract] Objective To study the role of antibiotics in perioperative period during elective laparoscopic cholecystectomy. Methods This randomized clinical trial, conducted from April 2012 to May 2015 at The Second Affiliated Hospital of An hui Medical Un iversity, in eluded 308 patie nts in prophylactic an tibiotic group (A group) with Cefotiam Hydrochloride 2.0g IV for two days and 312 in no antibiotic group(B group). Clinical indicators and situation after operation were observed and analyzed? Results 620 operations were completed according to routine protocol. There was no siginificant differenee in wound infections among the two groups (Pgt;O.O5):A group 1.9%(6/308) and B group 2.8%(9/312). Conclusion Elective laparoscopic cholecystectomy without antibiotics is safe and feasible. Key words］ elective laparoscopic cholecystectomy antibiotic infection 腹腔镜胆囊切除术现已成为治疗胆囊良性疾病的首选术式，在世界范围内已 广泛开展。围手术期预防性使用抗生素能降低术后感染发生率已是外科界的共识, 而对于择期腹腔镜胆囊切除术切口感染率在0.4%-1.1%的II类切口是否需要预防 性应用抗生素，尚存在争论［1, 2］。为了探讨择期腹腔镜胆囊切除术围手术期抗 生素应用的可行性及安全性，我们自2012年起选取了 620例行择期腹腔镜胆囊 切除术患者为研究对象，对围手术期抗生素应用后的疗效急性观察分析。 资料与方法 1?患者一般资料 选取我院2012年4至2015.05月我院住院部收治性择期腹腔镜胆囊切除术 患者620例患者为研究对象，按照先后入院顺序编号，按照随机的原则将编号奇 数患者分为A组，编号偶数患者分为B组；其中A组308例，男102例，女206 例，平均年龄为(35.8 plusmn;7.0),慢性结石性胆囊炎284例，胆囊息肉24 例;