论文部分内容阅读
目的探讨乳腺癌围手术期不使用抗菌药物对患者术后手术部位感染(SSI)的影响。方法回顾性分析2011年1月-2012年12月甲状腺乳腺外科收治的乳腺癌手术患者411例,将其分为对照组202例、研究组209例,对照组围手术期预防性使用抗菌药物,研究组围手术期不使用抗菌药物,观察两组患者SSI发生率,并对SSI发生及相关因素进行分析,数据采用SPSS13.0统计软件进行处理。结果 411例乳腺癌手术患者术后发生SSI2例,发生率为0.48%,对照组患者SSI发生率0.49%,研究组为0.48%,两组比较差异无统计学意义,证实乳腺癌术后SSI与是否应用抗菌药物无关;两组SSI患者在糖尿病、新辅助化疗、高龄等相关因素方面比较,差异无统计学意义;进一步分析发现,2例SSI均与术后皮下血肿及皮瓣坏死有关。结论乳腺癌术后SSI发生率与年龄、肥胖、糖尿病、术后创面血肿及血清肿等高危因素有关,与预防性使用抗菌药物无关,乳腺癌围手术期不使用抗菌药物并不增加SSI发生率,同时可以减少医疗费用,可以避免使用抗菌药物带来二次感染、耐药等问题,值得临床推广应用。
Objective To investigate the effect of perioperative non-use of antimicrobial agents on postoperative surgical site infection (SSI) in patients with breast cancer. Methods A retrospective analysis of 411 cases of breast cancer patients underwent surgery from January 2011 to December 2012 was divided into control group (n = 202) and study group (n = 209). The control group received perioperative prophylactic antibiotics, The study group did not use antimicrobial agents during perioperative period. The incidence of SSI in both groups was observed. The incidence of SSI and related factors were analyzed. The data were processed by SPSS13.0 statistical software. Results The incidence of SSI in 411 cases of breast cancer patients after operation was 2 cases, the incidence was 0.48%, the incidence of SSI in control group was 0.49% and that in study group was 0.48%, there was no significant difference between the two groups There was no significant difference between the two groups in SSI patients in terms of diabetes, neoadjuvant chemotherapy, advanced age and other related factors. Further analysis showed that both SSI and postoperative subcutaneous hematoma and skin flap necrosis related. Conclusion The incidence of postoperative SSI in breast cancer is related to the high risk factors such as age, obesity, diabetes mellitus, postoperative wound hematoma and serum edema, and has nothing to do with the prophylactic use of antimicrobial drugs. Perioperative period of breast cancer without antimicrobial agents does not increase the incidence of SSI , While reducing medical costs, avoid the use of antibacterial drugs such as secondary infection, drug resistance and other issues, it is worth promoting the clinical application.