骨科患者围术期应用抗菌药物对预防感染及炎症因子水平的影响

发布时间：2018-07-13 13:02

【摘要】：目的探讨骨科患者围术期应用抗菌药物对预防感染及炎症因子水平的影响。方法选取2014年1月-2015年12月医院骨科接受手术治疗的586例患者作为临床研究对象,采用随机数字表法将患者随机分为干预组294例和对照组292例,对照组患者围术期常规应用抗菌药物,干预组患者围术期干预性应用抗菌药物,比较两组患者感染率及炎症因子水平变化情况。结果对照组患者术前0.5~2h给药率为93.49%,药物不良反应发生率3.42%,手术切口感染率1.37%,干预组患者分别为97.62%、1.02%、0,两组比较差异有统计学意义(P0.05);对照组患者抗菌药物费用(1284.30±51.02)元,药费(2986.74±110.31)元,住院费用(9955.76±271.49)元,住院时间(12.65±2.08)d,干预组分别为(256.93±22.47)元、(2135.73±86.50)元、(8141.89±246.35)元、(8.92±1.54)d,两组比较差异有统计学意义(P0.05);对照组患者选择药物不合理率3.08%,联合用药不合理率2.40%,预防用药时机不合理率6.50%,术后用药时间过长发生率4.11%,干预组患者分别为0.68%、0.34%、2.38%、1.36%,两组比较差异有统计学意义(P0.05);对照组患者炎症因子TNF-α(68.62±8.16)pg/mL,IL-6(225.45±15.50)pg/mL,IL-8(398.75±36.21)pg/mL,CRP(12.81±2.03)mg/L;干预组患者分别为(40.65±6.02)pg/mL、(169.23±12.13)pg/mL、(329.87±32.24)pg/mL、(9.23±1.75)mg/L,两组比较差异有统计学意义(P0.05)。结论骨科患者围术期干预性应用抗菌药物对于预防手术感染,调节炎症因子,降低医疗费用,提高手术效果均具有十分重要的临床意义。
[Abstract]:Objective to investigate the effect of antimicrobial agents on the prevention of infection and the level of inflammatory factors in orthopaedic patients during perioperative period. Methods from January 2014 to December 2015, 586 patients undergoing surgical treatment in orthopedic department of hospital were selected as clinical study objects. 294 patients were randomly divided into intervention group (294 cases) and control group (292 cases) by random digital table. The patients in the control group were routinely treated with antibiotics during perioperative period, and the patients in the intervention group were treated with antimicrobial agents in perioperative period. The infection rate and the level of inflammatory factors were compared between the two groups. Results the rate of administration was 93.49, the incidence of adverse drug reaction was 3.42 and the infection rate of operative incision was 1.370.There were significant differences between the two groups (P0.05), the cost of antimicrobial agents was (1284.30 卤51.02) yuan, the drug cost was (2986.74 卤110.31) yuan, and the patients in the intervention group were 97.62 and 1.02, respectively (P0.05), while in the control group, the antibiotic cost was (1284.30 卤51.02) yuan, the drug cost was (2986.74 卤110.31) yuan, and that in the control group was (2986.74 卤110.31) yuan. The cost of hospitalization was (9955.76 卤271.49) yuan. The hospitalization time was (12.65 卤2.08) days, the intervention group was (256.93 卤22.47) yuan, (2135.73 卤86.50) yuan, (8141.89 卤246.35) yuan, (8.92 卤1.54) days, the difference between the two groups was statistically significant (P0.05); 闂磋繃闀垮彂鐢熺巼4.11%,骞查缁勬偅鑰呭垎鍒负0.68%,0.34%,2.38%,1.36%,涓ょ粍姣旇緝宸紓鏈夌粺璁″鎰忎箟(P0.05);瀵圭収缁勬偅鑰呯値鐥囧洜瀛怲NF-伪(68.62卤8.16)pg/mL,IL-6(225.45卤15.50)pg/mL,IL-8(398.75卤36.21)pg/mL,CRP(12.81卤2.03)mg/L;骞查缁勬偅鑰呭垎鍒负(40.65卤6.02)pg/mL,(169.23卤12.13)pg/mL,(329.87卤32.24)pg/mL,(9.23卤1.75)mg/L,涓ょ粍姣旇緝宸紓鏈夌粺璁″鎰忎箟(P0.05). Conclusion Interventional application of antimicrobial agents in orthopedic patients during perioperative period is of great clinical significance in preventing surgical infection, regulating inflammatory factors, reducing medical expenses and improving the effect of operation.
【作者单位】：郑州市骨科医院脊柱三科;郑州大学第一附属医院骨科三病区;
【分类号】：R687.3

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