食管癌患者围手术期抗菌药物选用与术后肺部感染的相关性研究

发布时间：2018-10-08 20:56

【摘要】：目的探讨食管癌患者围手术期抗菌药物的选用与术后肺部感染的相关性,为临床合理用药提供参考。方法收集2012年4-11月医院284例食管癌手术患者临床资料,包括手术方式、美国麻醉师协会评分等数据,详细记录手术预防用抗菌药物的名称、剂量、初始给药及追加时间、手术持续时间等,使用SPSS 21.0统计软件进行单变量及多变量分析。结果 284例患者术后发生肺部感染68例,感染率23.94%;肺部感染患者痰标本分离出革兰阴性菌29株占96.67%,革兰阳性菌1株占3.33%;术前给药时机正确的有258例,占90.84%;210例患者手术持续时间3h,仅146例追加使用了抗菌药物;68例肺部感染患者使用第一代头孢菌素,患者使用第一、二代头孢菌素或头孢曲松及β-内酰胺酶抑制剂复方制剂后,肺部感染发生率分别为27.23%和17.20%,术前给药时机对术后肺部感染发生有显著影响,术中追加与否对术后肺部感染发生无显著影响。结论食管癌患者围手术期抗菌药物的选择对术后肺部感染并无影响,应严格遵循相关指南推荐用药。
[Abstract]:Objective to investigate the relationship between the choice of antibiotics and postoperative pulmonary infection in patients with esophageal cancer. Methods the clinical data of 284 patients with esophageal cancer from April to November 2012 were collected, including the operation method, the score of American anaesthetists and so on. The names, doses, initial administration and supplementary time of antibiotics for surgical prophylaxis were recorded in detail. The operation duration was analyzed by using SPSS 21. 0 statistical software for univariate and multivariate analysis. Results Sixty-eight cases of postoperative pulmonary infection occurred in 284 patients, and the infection rate was 23.940.The sputum samples of the patients with pulmonary infection isolated 29 Gram-negative bacteria (96.67m) and one Gram-positive bacteria (3.33). The operation lasted for 3 hours in 210 patients. Only 146 patients received additional antibiotics and 68 patients with pulmonary infection received the first generation cephalosporin, the first and second generation cephalosporins or ceftriaxone and 尾 -lactamases inhibitor compound preparation. The incidence of pulmonary infection was 27.23% and 17.20%, respectively. The timing of preoperative administration had a significant effect on the incidence of postoperative pulmonary infection, but there was no significant effect of intraoperative supplementation on postoperative pulmonary infection. Conclusion the choice of antibiotics in patients with esophageal cancer during perioperative period has no effect on postoperative pulmonary infection.
【作者单位】：四川省肿瘤医院药学部;
【基金】：中国药学会科技开发中心研究基金资助项目(2012DCST01OT23)
【分类号】：R735.1

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