【摘要】：目的分析口腔頜面外科患者手術(shù)感染發(fā)生的高危因素,并利用隨機(jī)對(duì)照試驗(yàn)比較兩種用藥策略的療效,為臨床合理使用抗菌藥物提供依據(jù)。方法收集醫(yī)院2012年5月-2013年4月收治的2 818例口腔頜面部外科手術(shù)患者資料,對(duì)術(shù)后感染患者進(jìn)行調(diào)查研究,并將66例感染患者的初始治療用藥方案隨機(jī)分為單用廣譜抗菌藥物組、聯(lián)合用藥組,每組各33例,主要觀察終點(diǎn)為局部感染控制,體溫、白細(xì)胞及中性粒細(xì)胞等恢復(fù)正常。結(jié)果 2 818例口腔頜面外科手術(shù)患者發(fā)生感染66例,感染率為2.34%,其中口腔頜面部腫瘤手術(shù)感染患者55例占83.33%;深部切口感染最高占77.27%,其次為下呼吸道、表淺切口和上呼吸道感染,分別占16.67%、4.55%和1.52%;年齡≥55歲、手術(shù)切口類型、特殊手術(shù)操作的術(shù)后感染患者相關(guān)因素比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);單用廣譜抗菌藥物組平均治療(7.30±0.89)d,聯(lián)合用藥組平均治療(5.30±0.45)d,經(jīng)kaplanmeier分析,差異有統(tǒng)計(jì)學(xué)意義(P0.05);治療中未發(fā)生抗菌藥物相關(guān)的不良反應(yīng)。結(jié)論口腔頜面部腫瘤手術(shù)、高齡、Ⅲ類手術(shù)切口、特殊手術(shù)操作類型患者發(fā)生感染風(fēng)險(xiǎn)較大;針對(duì)手術(shù)感染病例,早期聯(lián)用奧硝唑,可顯著縮短感染治療時(shí)間。
[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 鹵0.89) days, and the average treatment days in combination group was (5.30 鹵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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