【摘要】：目的:分析骨科無菌手術(shù)中不同抗菌藥物(青霉素、環(huán)丙沙星、阿米卡星、氨芐西林、紅霉素、妥布霉素、慶大霉素、頭孢唑啉、諾氟沙星和萬古霉素)對切口感染致病菌的耐藥情況。方法:選取2014年8月—2016年11月間收治的骨科無菌手術(shù)患者104例,將其分成A組和B組,每組52例;A組患者于麻醉誘導(dǎo)期、術(shù)中和術(shù)后第3天給予抗菌藥物預(yù)防感染,B組患者于術(shù)后到切口拆線時間內(nèi)給予抗菌藥物預(yù)防感染;比較兩組患者預(yù)防感染用藥后切口感染的發(fā)生率,以及致病菌的藥敏試驗結(jié)果。結(jié)果:A組患者用藥后切口感染的發(fā)生率為3.85%低于B組為19.23%(P0.05),未發(fā)生混合感染,而B組患者混合感染的發(fā)生率為7.69%(P0.05);A組患者共培養(yǎng)出2株革蘭陽性球菌,B組共培養(yǎng)出5株革蘭陽性球菌和2株革蘭陰性桿菌;分離出的致病菌對多種抗菌藥物有耐藥性。結(jié)論:骨科無菌手術(shù)患者在麻醉誘導(dǎo)期、術(shù)中和術(shù)后第3天采用抗菌藥物預(yù)防感染,優(yōu)于術(shù)后給藥,但需注意的是不可任意延長抗菌藥物的用藥時間,以免提高感染的發(fā)生率和耐藥性。
[Abstract]:Objective: to analyze different antimicrobial agents (penicillin, ciprofloxacin, amikacin, ampicillin, erythromycin, tobramycin, gentamicin, cefazolin) in aseptic orthopedic surgery. Norfloxacin and vancomycin) resistance to wound infection pathogens. Methods: 104 patients undergoing orthopedic aseptic surgery from August 2014 to November 2016 were divided into two groups: group A (52 cases) and group B (52 cases). The patients in group A were given antibiotics to prevent infection during anesthesia induction period, intraoperative and postoperative 3 days, and patients in group B were given antibiotics to prevent infection within the time from postoperative to incision. The incidence of incision infection and the results of antibiotic sensitivity test were compared between the two groups. Results: the incidence of incision infection in group A was lower than that in group B (3.85% vs 19.23%, P0.05), but the incidence of mixed infection in group B was 7.69% (P0.05). Two strains of gram-positive cocci were cultured in group A, five strains of gram-positive cocci and two strains of gram-negative bacilli were cultured in group B. the isolated pathogenic bacteria were resistant to many antimicrobial agents. Conclusion: during anesthesia induction period, during operation and 3 days after operation, the patients undergoing orthopedic aseptic surgery should use antibiotics to prevent infection, which is superior to postoperative administration, but it should not be arbitrarily prolonged. Avoid increasing the incidence of infection and drug resistance.
【作者單位】： 奉新縣中醫(yī)院骨科;
【分類號】：R446.5;R687

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