摘要
目的分析预防性应用抗生素是否降低分流手术术后感染率,探讨影响分流手术术后感染率的危险因素。方法采用回顾性队列研究,分析天津市环湖医院神经外科2010年10月-2015年10月5年间分流手术病例,按照术前是否预防性应用抗生素分为预防性应用抗生素组(antibiotic prophylaxis,AP)和未预防性应用抗生素组(non-antibiotic prophylaxis,n-AP),观察两组病例术后感染率有无差别;应用Logistic回归分析分流术后感染率的影响因素。结果 101例分流手术病例纳入研究,AP组54例感染2例,n-AP组47例感染3例,两组间感染率差异无统计学意义(χ~2=0.383,P=0.576);术后感染率与既往颅内感染病史有关(OR=34.50,P=0.000),5例术后感染病例中脑脊液细菌培养阳性3例,其中2例为表皮葡萄球菌,1例为粪肠球菌。AP组与n-AP组平均住院天数差异无统计学意义,但感染组与非感染组住院天数差异有统计学意义。结论预防性应用抗生素并不能降低分流手术术后感染率;颅内感染史为分流术后感染的危险因素;表皮葡萄球菌为分流术后颅内感染常见致病菌,感染显著延长住院时间。
Objective To analyze if Antimicrobial prophylaxis can reduce the infection rate of shunt surgery and investi- gate the risk factors. Methods The shunt surgery cases which were done from 2010.10 to 2015.10 in the 8th Department of neu- rosurgery in Tian Jin HuauHu Hospital were chosen. The cases were dived into Antibiotic prophylaxis group and non- Antibiotic prophylaxis group according to the use of antibiotic pre-opcration. Analyzed the infection rate of the two groups after surgery. Re- sults In totally, 101 cases were chosen, AP group 54 cases with 2 cases infection and n-AP group 47 cases with 3 cases infec- tion, there was no statistical difference between the two groups in infeetion（x2= 0. 383 ,P= 0. 576） ; Preoperative intracranial in- fection was closely related to the infection rate（ OR = 34. 50,P= 0. 000）. In the 5 infection cases, 3 cases had the positive result of cerebrospinal fluid culture, 2 with Epidermis staphylococcus and 1 with enterocoecus faecalis. There was no statistical differ- ence between the AP and n-AP group in the days of stay in hospital after surgery, but there was statistically significant difference between the？ infection group and non-？ infection group. Conclusion Antimicrobial prophylaxis can not shorten the time of stay in hospital and reduce the infection rate. Epidermis staphylococcus is the most common pathogenic bacteria of？ intracranial infec- tion after operation, infection lead to prolong the time of stay in hospital.
出处
《解放军预防医学杂志》
CAS
2017年第3期234-237,共4页
Journal of Preventive Medicine of Chinese People's Liberation Army
基金
国家自然科学基金(No.81302204)
天津市卫生局科技基金(No.2013KR09)天津市卫生局青年基金(No.2013KY14)
关键词
预防性
抗生素
分流手术
感染
prophylactic
antibiotics
shunt surgery
infection
