Ruangsin Sakchai, Wanasuwannakul Thunchanok
Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
J Med Assoc Thai. 2012 Jan;95(1):48-51.
Evaluate the effectiveness of variation of prophylactic antibiotic in laparoscopic cholecystectomy.
A retrospective data review was undertaken of patients who received a laparoscopic cholecystectomy between January 1, 2005 and December 31, 2008 in Songklanagarind Hospital. The prevalence of surgical site infection (SSI), the variation of antibiotic prescription, and associated factors with SSI were reviewed and analyzed.
Four hundred thirty nine patients received a successful laparoscopic cholecystectomy. The prophylactic antibiotic was utilized in 328 patients (74.7%). Cefazolin was the most common antibiotic used. Only 3 patients (0.9%) received the antibiotic according to the recommendation of center for disease control and prevention (CDC). The SSI was accounted in 41 patients (9.3%); 29 had the prophylactic antibiotic, while 12 did not. There was no statistically significant difference in the prevalence of SSI between the two groups (p = 0.54). Factor significantly associated with SSI was the operative time more than three hours (p = 0.03).
Various patterns of prophylactic antibiotic were encountered. The practice variation seemed to be ineffective in the prevention of SSI. The selectively risk factors should be considered in the antibiotic prophylaxis.
评估预防性抗生素在腹腔镜胆囊切除术中应用变化的有效性。
对2005年1月1日至2008年12月31日在宋卡纳卡林医院接受腹腔镜胆囊切除术的患者进行回顾性数据审查。回顾并分析手术部位感染（SSI）的发生率、抗生素处方的变化以及与SSI相关的因素。
439例患者成功接受了腹腔镜胆囊切除术。328例患者（74.7%）使用了预防性抗生素。头孢唑林是最常用的抗生素。只有3例患者（0.9%）根据疾病控制与预防中心（CDC）的建议使用了抗生素。41例患者（9.3%）发生了SSI；29例使用了预防性抗生素，12例未使用。两组之间SSI的发生率无统计学显著差异（p = ）。与SSI显著相关的因素是手术时间超过3小时（p = 0.03）。
遇到了多种预防性抗生素使用模式。这种实践差异在预防SSI方面似乎无效。在抗生素预防中应考虑选择性危险因素。
