摘要
目的 观察永久性心脏起搏器植入术前抗菌药物的使用时机对老年患者术后感染的影响。方法 选取南昌市第一医院2019年1月-2020年6月期间90例行永久性心脏起搏器植入术的老年患者为研究对象,根据术前抗菌药物使用情况分为A、B、C三组,每组30例。A组患者术前3 d开始预防性使用抗菌药物,B组患者术前1 d开始预防性使用抗菌药物,C组术前不使用。观察三组患者术后发热、感染、不良反应发生情况,分析抗菌药物成本-效果比及炎性因子水平表达情况。结果 三组术后发热患者占比、不良反应无统计学差异,三组术后感染率差异显著(P<0.05);三组患者白细胞计数、C-反应蛋白、白细胞介素-1水平比较差异有统计学意义(P<0.05),A、B两组患者炎性因子水平比较差异无统计学意义,但均低于C组(P<0.05);三组患者抗菌药物费用及成本-效果比比较差异有统计学意义(P<0.05),其中在能有效降低患者感染发生率的同时,B组成本-效果比低于A组(P<0.05)。结论 老年永久性心脏起搏器植入术前1 d,术后3 d预防性使用抗菌药物能有效的预防术后感染,降低治疗费用,是一种有效、经济的抗菌药物使用方案。
OBJECTIVE To observe the effect of the timing of antibiotics use before permanent pacemaker implantation on postoperative infection in elderly patients. METHODS A total of 90 elderly patients who underwent permanent pacemaker implantation in the First Hospital of Nanchang from Jan. 2019 to Jun. 2020 were selected as the research subjects, and were divided into three groups A, B and C according to the preoperative use of antibiotics, with 30 cases in each group. Patients in group A received antibiotics prophylactically 3 days before operation, patients in group B were given antibiotics preventively 1 day before operation, and patients in group C did not receive antibiotics before operation. The incidence of postoperative fever, infection and adverse reactions of the three groups were observed, and the cost-effectiveness ratio of antibiotics and the expression of inflammatory factors were analyzed. RESULTS There were no significant differences in the proportion of postoperative fever patients and adverse reactions among the three groups, while there were significant differences in the postoperative infection rate among the three groups(P<0.05);There were significant differences in the levels of leukocyte count, C-reactive protein and interleukin-1 among the three groups(P<0.05). There were no significant differences in the levels of inflammatory factors between group A and group B, but they were lower than those in group C(P<0.05). There were significant differences in the cost and cost-effectiveness ratio of antibiotics among the three groups(P<0.05). While effectively reducing the incidence of infection, the cost-effectiveness ratio of group B was lower than that of group A(P<0.05). CONCLUSION The prophylactic use of antibiotics 1 day before and 3 days after implantation of permanent pacemaker in the elderly can effectively prevent postoperative infection and reduce the treatment cost, which is an effective and economical use of antibiotics.
作者
涂颉洪
戴月
江小杰
李军华
肖冬平
黄鑫
TU Jie-hong;DAI Yue;JIANG Xiao-jie;LI Jun-hua;XIAO Dong-ping;HUANG Xin(The First Hospital of Nanchang,Nanchang,Jiangxi 330008,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2022年第12期1794-1797,共4页
Chinese Journal of Nosocomiology
基金
江西省卫生健康委科技基金资助项目(20204002)。
