摘要
目的:探讨自体颅骨和三维塑形钛网颅骨成形术使用不同抗菌药物预防感染的效果。方法:回顾性分析本研究中心2016年6月-2021年2月符合纳入标准的颅骨成形术患者资料,共45例。按颅骨修补材料分为自体颅骨组(19例)和三维塑形钛网组(26例)。以90 d内手术部位感染率、体温、WBC、N%和CRP为观察指标,分析比较自体颅骨组与三维塑形钛网组术后24、72、168 h体温、感染相关实验室指标的变化情况以及不同抗菌药物(单用头孢唑啉,术后更换广谱抗菌药)、不同疗程(≤72 h,96~144 h,>144 h)对两种修补材料术后感染的影响。结果:两种修补材料术后患者体温、WBC、N%和CRP同期比较无统计学差异(P>0.05),变化趋势相同;抗菌药物品种、用药疗程对两种修补材料术后感染相关实验室指标的影响均无统计学差异(P>0.05)。结论:推荐使用头孢唑林、短疗程(≤72 h)预防感染,但最短有效疗程尚需进一步研究。
Objective:To explore the effect of different prophylactic antibiotics for autologous skull and three-dimensional shaping titanium mesh cranioplasty.Methods:The data of 45 patients with cranioplasty who met the inclusion criteria from June 2016 to February 2021 were analyzed retrospectively.All patients were divided into autologous skull group(19 cases)and three-dimensional shaping titanium mesh group(26 cases)according to the skull repair material.The observation indexes were the infection rate of surgical site,body temperature,WBC,N%and C-reactive protein(CRP)within 90 days.The body temperature and infection-related laboratory indexes at 24,72,168 hours after operation in two groups were compared.And the effect of different antibiotics(using cefazolin alone vs upgrading to broad-spectrum antibiotics after operation),effects of different course of treatment of antibiotics(≤72 h,96-144 h,>144 h)on postoperative infection of two kinds of repair material.Results:The body temperature,WBC,N%and CRP of patients after operation in the two groups showed the same trend,and there was no significant difference between them(P>0.05).The effects of different antibiotics and course of treatment on postoperative infection-related laboratory indexes were not significant between the two groups(P>0.05).Conclusion:Cefazolin and short course of prevention(≤72 h)were recommended.But the shortest and effective course of treatment needs to be further studied.
作者
张莹
朱文昱
王为华
闫可
李彩云
黄立峰
ZHANG Ying;ZHU Wen-yu;WANG Wei-hua;YAN Ke;LI Cai-yun;HUANG Li-feng(Department of Pharmacy,theAffiliated Suzhou Science&Technology Town Hospital of Nanjing Medical University,Suzhou 215153,China;Department of Neurosurgery,theAffiliated Suzhou Science&Technology Town Hospital of Nanjing Medical University,Suzhou 215153,China)
出处
《中国药物应用与监测》
CAS
2021年第6期355-358,共4页
Chinese Journal of Drug Application and Monitoring
基金
江苏省药学会基金项目(A201935)。
关键词
预防用抗菌药物
手术部位感染
颅骨成形术
自体颅骨
钛网
Prophylactic antibiotics
Surgical site infection
Cranioplasty
Autologous skull
Titanium mesh
