兰州大学机构库 >学院待认领
预防性抗菌素应用在永久起搏器植入术中的临床研究
Alternative TitleThe clinical analysis on the prophylactic use of antibiotics during perioperative period in cardiac permanent pacemaker implanting
陈芝蔷
Thesis Advisor白锋
2015-05-14
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Keyword心脏起搏器 预防性 抗菌素 围手术期
Abstract目的:通过对722例植入起搏器患者围术期应用抗生素的特点进行分析,为选择安全、规范、经济的预防性应用抗菌素方案提供临床依据。 方法:选取2010年1月至2013年12月兰大二院和陆军总院安装的起搏器病例共722例,根据抗生素使用方案不同,将患者分为四组,A、B、C三组均在术前用抗生素一次,术后A组使用平均6.52±1.13天、B组3天、C组未使用,D组围术期未使用。四组患者术后第1、3、5天常规各换敷料1次,住院期间观察手术切口和囊袋情况,分别在术后1月、3月随访1次。 结果:(1)基本资料比较:差异无统计学意义(P>0.05)。(2)术后发热率:四组相比较,差异无统计学意义(P>0.05)。(3)术后切口红肿及囊袋积血发生率:四组比较差异无统计学意义(P>0.05)。(4)术后感染发生率:四组患者以D组为对照组两两比较,差异无统计学意义(P>0.05)。 结论:结合本研究以及其他的研究结果,建议起搏器术前预防性静脉滴注抗生素治疗,术后应根据患者切口及全身情况给药。起搏器装置感染的发生更多可能与更换电极、多次重建有关,研究结果为起搏器植入术围术期预防性应用抗生素提供更有价值的临床依据。
Other AbstractObjective: This is a retrospective clinical analysis for the infections related features of using antibiotic in preoperative period of permanent cardiac pacemaker for 722 patients, which aimed to help better understanding how to choose a reasonable and standardized prophylactic antimicrobial application for the patients with permanent cardiac pacemaker during the preoperative period. Methods: Seven hundreds and twenty-two patients with single, dual and three chamber cardiac pacemaker from Cardiology Department of Lanzhou University Second Hospital and Cardiology Department of General Hospital of Lanzhou Military Command between January 2010 and December 2013. According to the different antibiotic use program, the patients were divided into four groups, including group A(n=187cases), group B(n=183), group C(n=174) and group D(n=178), respectively. In group A, B and C, the patients used prophylactic intravenous antibiotics 30min-1 hour before the surgery and used antimicrobial agents (1 time/12hour) after the surgery. Patients of group A used antimicrobial agents for more than three days (average 6.52 ± 1.13 days), and group B for three days, and Group C did not used. But Group D didn’t use any antibiotics before and after the surgery. We changed the four groups of patients in the first, third and fifth day after the surgery, observed surgical incision and pacemaker pocket at the time of hospitalization, and followed up at the first and third month respectively after the surgery. Finally apply SPSS22.0 statistical software was applied to analyze the data. Results:(1) Basic data comparison between the four groups: four groups of patients with gender, age, basic information, such as body temperature, blood routine preoperative general data comparison, had no differences (P > 0.05), comparable. (2) The observations:A group of 4 cases of postoperative fever rate was 2.14%, 3 cases of group B was 1.63%, 5 cases of group C was 2.87%, 2 cases of group D was 1.12%, compared four groups, had no differences (P > 0.05).(3)Postoperative incision inflammation and pocket 7 cases of group A was 3.74%, the incidence of hemorrhage 4 cases of group B was 2.19%, 5 cases (2.87%), group C group D 3 cases (1.69%), four groups of comparative differences have no statistical significance (P > 0.05).Pocket hemorrhage patients via local sandbags oppression and cut after removal of hemorrhage, incisions healed well.(4)The incidence of postoperative infection, 2 cases of ...
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Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/222290
Collection学院待认领
Affiliation临床医学院
Recommended Citation
GB/T 7714
陈芝蔷. 预防性抗菌素应用在永久起搏器植入术中的临床研究[D]. 兰州. 兰州大学,2015.
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