口腔颌面外科患者术后感染因素分析研究

发布时间：2018-09-12 13:23

【摘要】：目的分析口腔颌面外科患者手术感染发生的高危因素,并利用随机对照试验比较两种用药策略的疗效,为临床合理使用抗菌药物提供依据。方法收集医院2012年5月-2013年4月收治的2 818例口腔颌面部外科手术患者资料,对术后感染患者进行调查研究,并将66例感染患者的初始治疗用药方案随机分为单用广谱抗菌药物组、联合用药组,每组各33例,主要观察终点为局部感染控制,体温、白细胞及中性粒细胞等恢复正常。结果 2 818例口腔颌面外科手术患者发生感染66例,感染率为2.34%,其中口腔颌面部肿瘤手术感染患者55例占83.33%;深部切口感染最高占77.27%,其次为下呼吸道、表浅切口和上呼吸道感染,分别占16.67%、4.55%和1.52%;年龄≥55岁、手术切口类型、特殊手术操作的术后感染患者相关因素比较,差异有统计学意义(P0.05);单用广谱抗菌药物组平均治疗(7.30±0.89)d,联合用药组平均治疗(5.30±0.45)d,经kaplanmeier分析,差异有统计学意义(P0.05);治疗中未发生抗菌药物相关的不良反应。结论口腔颌面部肿瘤手术、高龄、Ⅲ类手术切口、特殊手术操作类型患者发生感染风险较大;针对手术感染病例,早期联用奥硝唑,可显著缩短感染治疗时间。
[Abstract]:Objective to analyze the high risk factors of surgical infection in patients with oral and maxillofacial surgery, and to compare the efficacy of the two drug strategies with randomized controlled trials in order to provide evidence for the rational use of antimicrobial agents in clinic. Methods data of 2818 patients with oral and maxillofacial surgery were collected from May 2012 to April 2013 in our hospital. 66 patients with infection were randomly divided into two groups: the group treated with broad-spectrum antimicrobial drugs and the group treated with combined antibiotics. The main endpoints were local infection control, body temperature, leukocyte and neutrophil. Results among the 2 818 patients undergoing oral and maxillofacial surgery, 66 cases (2.34%) were infected, 55 cases (83.33%) were infected by oral and maxillofacial tumor surgery, 77.27 cases were infected by deep incision, followed by infection of lower respiratory tract, superficial incision and upper respiratory tract. There were significant differences in the relative factors of postoperative infection patients aged more than 55 years, surgical incision types and special surgical procedures (P0.05), the average treatment of broad-spectrum antibacterial drugs group was (7.30 卤0.89) days, and the average treatment days in combination group was (5.30 卤0.45) days, which was analyzed by kaplanmeier. The difference was statistically significant (P0.05); there were no adverse reactions related to antimicrobial agents in the treatment. Conclusion patients with oral and maxillofacial neoplasms, elderly, type 鈪，

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