摘要
目的探讨小儿尿道下裂手术预防性应用抗生素是否能够带来益处。方法选择2018年6月—2020年6月在该院住院的小儿尿道下裂患儿90例进行前瞻性研究,按照是否应用抗生素和抗生素应用时间随机分为A、B、C 3组,每组30例。其中A组不用抗生素;B组围术期用1次抗生素;C组围术期应用3 d抗生素。观察各组术后尿液细菌培养阳性率和并发症发生率。结果3组术后1、3 d尿液细菌培养结果比较,差异有统计学意义(P<0.05);术后1 d,A组尿液细菌培养阳性13例,高于B组(3例)、C组(4例);术后3 d,A组尿液细菌培养阳性15例,高于B组(4例)、C组(4例),差异有统计学意义(χ^(2)=11.700、14.134,P<0.05),术后7 d,A组尿液细菌培养阳性8例,高于B组(3例)、C组(2例),差异无统计学意义(χ^(2)=5.574,P>0.05);3组前段型与后段型比较,差异无统计学意义(χ^(2)=1.519,P>0.05);3组患儿在并发切口感染、尿瘘、尿道狭窄以及再次手术等指标上差异无统计学意义(χ^(2)=0.523、0.207、1.023、0.207,P>0.05)。结论在手术条件和病房清洁条件较好的医院,并有严格的术前、术后预防感染的护理措施,尿道下裂患儿围术期可以不使用抗生素,是否使用抗生素对治疗结局没有影响。即使使用抗生素,也不应超过术后3 d。
Objective To investigate whether prophylactic antibiotics in pediatric hypospadias surgery can be beneficial.Methods 90 children with hypospadias who were hospitalized in the hospital from June 2018 to June 2020 were selected for prospective study,and they were randomly divided into three groups A,B,and C according to whether antibiotics were used and the duration of antibiotic application,with 30 patients in each group.Among them,group A:no antibiotics;group B:one-time antibiotics during perioperative period;group C:3 d antibiotics during perioperative period.The positive rate of urine bacterial culture and the incidence of complications in each group were observed.Results There was statistically significant difference in the results of urine bacterial culture among the three groups at 1 d and 3 d after operation(P<0.05);13 cases of positive urine bacterial culture in group A were higher than those in group B(3 cases)and group C(4 cases)on the 1 d postoperative day,and 15 cases in group A with positive urine bacterial culture on the 3 d after operation were higher than those in group B(4 cases),group C(4 cases),the difference was statistically significant(χ^(2)=11.700,14.134,P<0.05);7 d after operation,there were 8 cases of positive urine bacterial culture in group A,which was higher than that in group B(3 cases)and group C(2 cases),the difference was not statistically significant(χ^(2)=5.574,P>0.05);there was no statistically significant difference between the three groups of anterior segment type and posterior segment type(χ^(2)=1.519,P>0.05);there was no statistically significant difference in the three groups of wound infection,urinary fistula,urethral stricture and reoperation with clinical symptoms(χ^(2)=0.523,0.207,1.023,0.207,P>0.05).Conclusion In hospitals with better surgical conditions and ward cleanliness,and strict nursing measures to prevent infection before and after surgery,children with hypospadias may not use antibiotics during the perioperative period,and the use of antibiotics has no effe
作者
王剑锋
谢旭敏
凌枫盛
伍华焱
何军
张世林
刘国庆
WANG Jianfeng;XIE Xumin;LING Fengsheng;WU Huayan;HE Jun;ZHANG Shilin;LIU Guoqing(Department of Surgery,Foshan Maternity and Child Health Hospital Affiliated to Southern Medical University,Foshan,Guangdong Province,528000 China)
出处
《世界复合医学》
2022年第2期131-133,141,共4页
World Journal of Complex Medicine
