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目的:分析未预防性应用抗菌药物的小儿腹股沟疝修补术术后发热及感染情况,供临床用药参考。方法:选取2013-2015年在郑州儿童医院行腹股沟疝修补手术围术期未预防用抗菌药物的患儿2 309例,根据手术前后腋下体温变化及手术部位感染情况分析是否需要应用抗菌药物。结果:2 309例患儿中,左侧腹股沟斜疝871例,右侧腹股沟斜疝1 306例,双侧腹股沟斜疝132例。单侧腹股沟斜疝患儿术后发热52例(2.39%),双侧腹股沟斜疝患儿术后发热8例(6.06%),均经物理降温或药物等对症处理后体温恢复正常。2013年、2014年、2015年手术部位感染率分别为0.13%(1/785)、0.13%(1/753)、0.26%(2/771),两两比较差异无统计学意义(P>0.05),均符合清洁手术切口感染率小于1%的规定。结论:术后发热是机体对手术创伤性炎症的正常反应,是由于手术组织损伤引起的非感染性发热,应避免盲目使用抗菌药物,只有术后切口感染的发热患儿才需要应用抗菌药物。
OBJECTIVE: To analyze the postoperative fever and infection in pediatric inguinal hernia after unprotected use of antimicrobial agents for clinical reference. Methods: A total of 2 309 children with perioperative non-prophylactic antibiotics received inguinal hernia repair in Zhengzhou Children’s Hospital from 2013 to 2015 were selected. Antibacterials were selected according to the changes of underarm temperature before and after surgery and the infection of the surgical site. Results: Among 2 309 children, there were 871 cases of left inguinal hernia, 1 306 cases of right inguinal hernia and 132 cases of bilateral inguinal hernia. 52 cases (2.39%) had fever after unilateral inguinal hernia, and 8 cases (6.06%) had postoperative fever with bilateral inguinal hernia. All patients returned to normal body temperature after symptomatic treatment by physical cooling or drugs. The infection rates of surgical sites in 2013, 2014 and 2015 were 0.13% (1/785), 0.13% (1/753) and 0.26% (2/771), respectively, with no significant difference (P> 0.05 ), Are in line with clean incision infection rate of less than 1% of the provisions. Conclusion: The postoperative fever is the normal reaction of the body to the traumatic inflammation of the operation. It is due to the non-infectious fever caused by the surgical tissue injury. Anti-bacterial drugs should be avoided blindly. Only antibiotics should be used in children with fever after incision infection.