| Clean operation refers to the operation did not enter the inflammationarea,did not enter the respiratory,digestive,urogenital and blunt traumaoperation.Is a common thyroid operation,breast operation, hernia repair for3surgical cleaning operation of clean incision operation, the operation field forhuman sterile sites,such as the absence of exceptional circumstances orhigh-risk groups,usually without prophylactic use of antimicrobial agents.Clean operation of thyroid is applied and how to reasonable use of antibioticsand lack of clinical research data,widely used,the unreasonable application ofantibiotics and abuse,causing bacteria generally resistant and multidrugresistance, which clinical failure and recurrence of infection, increased the riskof death pose a great threat to human health.Objective:This topic through the retrospective analysis of thyroid cleaningoperation in operation period antibiotic prophylaxis with and withoutapplication of antibiotics has no difference,to explore the feasibility of usingantibiotics not clean operation of thyroid operation period,in order to improvethe rationality of clinical medicine.Methods：1Research subjects: a retrospective analysis of clinical data of patientswith thyroid cleaning operation in2006January to2012November weretreated in the Department of general surgery of Central Hospital of ChaoyangCity.At the same time, exclusion of patients with diabetes,immunedysfunction, malnutrition and the presence of preoperative patients withinfections,a total of1165patients were selected,including267males,898females;the ratio of male to female was1:3.4,age20~69years old (average 46.35years).The following groups:Do not use of antibiotics for the observation group:230cases,male53cases,female177cases;age (41.9±11.86) years old.Operation time (min) of132.6±0.58.Application of antibiotics for the control group:935cases,male214cases,female721cases,age (50.88±11.85) years old.Operation time (min) of134.4±0.62.2Observation index:by observing the general situation of the patients inthe two groups (case number,sex,age,operation time) and the rate ofpostoperative incision infection,third days of screening blood white blood cellcount and neutrophil ratio,drainage time after operation and hospitalizationtime,recovery of two groups of patients with postoperative has no differences.3Antibiotic drugs:observation group:no antibiotics.Control group:preventive medication:preoperative0.5~2h starting drug intravenousantibiotic,operation time more than3hours,or blood volume (>1500ml), canbe given second agents in operation,postoperative administered every6h untilthe end of24h.4statistical methods:statistical analysis of data by SPSS17software.Themeasurement data with x±s, group increased significantly compared withX2test,count data using t test,P <0.05had significant difference.Results:1Patients in the two groups by balance test,gender,age,illness and othersimilar basic constitution,comparable (P>0.05).2The observation group of230cases of thyroid patients without use ofantibiotics in229patients without infection,1cases of patients with infection,the infection rate was0.4%;the control group of935cases of thyroid patientsuse of antibiotics in931patients without infection,4cases of patients withinfection, the infection rate was0.4%.Statistical analysis of infection in twogroups of patients,no significant difference (P>0.05).3White blood cell count (×109/L):observation group and control groupwere7.78±0.73,7.72±0.87,2groups of patients were t test, P>0.05, no significant difference.Neutrophil ratio (%):the observation group and thecontrol group were72.43±4.85,71.77±5.02,2groups of patients were t test,P>0.05, no significant difference.Drainage time (d): the observation groupand the control group were2.80±0.67,2.84±0.83,2groups of patients were ttest, P>0.05, no significant difference.The hospitalization time (d):theobservation group and the control group were6.72±0.84,6.75±0.90,2groupsof patients were t test,P>0.05,no significant difference.Conclusion:1Clinical data of retrospectively reviewed1165patients aged20-69years cleaning operation of thyroid patients,which does not use of antibioticsfor the observation group of230cases,operation time (132.6±0.58) min;application of antibiotics as the control group were935cases,operation time(134.4±0.62) min. Two groups of patients by balance test, gender, age, illnessand other similar basic constitution,comparable (P>0.05).2The observation group and the control group after third days of whiteblood cell count (×109/L),the ratio of neutrophils,postoperative wounddrainage rate had no significant difference between time and incision infection,hospitalization time (P>0.05).3This study shows that, as long as through careful preoperativepreparation,strict aseptic technique in operation,careful postoperative care useof antibiotics to prevent thyroid disease not during operation is safe.Perioperation period does not prevent the use of antibiotics,which can reduce theeconomic burden of the patients, but also can prevent and lead to bacterialresistance due to excessive use of antimicrobial agents.And do not useantibiotics had no significant difference in the recovery of patients afterthyroidectomy cleaning operation prophylactic use of antibiotics,promptprophylactic use of antibiotics can not effectively improve the cleaningoperation of thyroid patients after recovery. |
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