摘要
目的探讨预防性抗菌药物的应用是否能降低永久性心脏起搏器植入患者术后炎症指标水平及囊袋感染的发生率。方法回顾性分析2010年1月-2016年6月于医院心血管内科接受永久性心脏起搏器植入手术的患者共计127例,对符合标准的患者119例进行研究,分为对照组63例和研究组56例;其中对照组围手术期规范应用抗菌药物;研究组围手术期未使用抗菌药物。对两组患者一般资料、术后炎症指标、囊袋感染情况进行分析。结果对照组患者术后囊袋感染率为6.35%(4/63),研究组为5.36%(3/56),两组差异无统计学意义(P=0.872)。同组患者术后的C-反应蛋白(CRP)、血沉(ESR)及降钙素原(PCT)均高于术前指标(P<0.05);但两组之间同时间段炎症指标水平差异无统计学意义。研究组有1例发生严重囊袋感染,经手术扩创、更换起搏器位置后治愈。结论永久性心脏起搏器植入患者围手术期应用抗菌药物对于术后炎症指标及囊袋感染发生率的影响并不显著,但围手术期应用抗菌药物可能有助于预防严重感染。
OBJECTIVE To investigate whether the prophylactic use of antibiotics can reduce the level of inflammatory markers and incidence of pocket infection after implantation of permanent cardiac pacemaker.METHODS A total of 127 patients with permanent cardiac pacemaker implantation from Jan.2010 to Jun.2016 in the department of cardiology of the hospital were retrospectively analyzed,and 119 cases of patients with compliance with the standard were analyzed,which were divided into control group（63 cases）and observation group（56 cases）.Patients in control group used antibiotics during the perioperative period,and patients in observation group did not use antibiotics.The general data of the patients,the level of inflammatory marker and the incidence of pocket infection were analyzed.RESULTS The incidence of pocket infection in control group was 6.35 %（4/63）and that in observation group was 5.36%（3/56）,and the difference between the two groups was not significant（P=0.872）.The levels of C reactive protein（CRP）,erythrocyte sedimentation rate（ESR）and procalcitonin（PCT）after operation were significantly higher than those before operation in the same group（P〈0.05）.However,there was no significant difference in the levels of inflammation markers between the two groups in the same period.There was one case of severe pocket infection in observation group,which was cured after debridement and the adjustment if the pacemaker.CONCLUSIONThe influence of use of antibiotics in patients with implantation of permanent cardiac pacemaker in perioperative period on levels of inflammatory markers and incidence of pocket infection is not significant,but using antibiotics may be helpful to prevention severe infection.
作者
张鹏
陈建辉
马江敏
ZHANG Peng;CHEN Jian-hui;MA Jiang-min(PLA 91st Central Hospital, Jiaozuo, Henan 454000, China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2018年第12期1846-1848,共3页
Chinese Journal of Nosocomiology
基金
马江敏
E-mail:72495WSC@163.com
关键词
永久性心脏起搏器
囊袋感染
围手术期
抗菌药物
Permanent cardiac pacemaker
Pocket infection
Perioperative period
Antibiotics
