目的 分析可能影響2016年10月—2018年10月北部戰(zhàn)區(qū)總醫(yī)院935例行骨科Ⅰ類切口手術(shù)的住院患者術(shù)后炎癥發(fā)生率的因素；回顧不同術(shù)區(qū)選擇抗菌藥物的種類及應(yīng)用療程，為臨床個體化使用抗菌藥物提供參考。方法 使用Excel 2010及SPSS 20.0軟件對所選取的研究對象進(jìn)行統(tǒng)計(jì)，分析。結(jié)果 脊柱與髖部的發(fā)病人群年齡晚于其他部位；上肢、腿部、足踝等部位男性發(fā)病年齡較早。脊柱組炎癥發(fā)生率（41.08%）高于周邊組（15.50%）；伴與不伴發(fā)糖尿病，脊柱組患者術(shù)后炎癥發(fā)生率無差別；但糖尿病可能提高周邊組術(shù)后炎癥發(fā)生率。使用抗生素骨水泥可降低脊柱組炎癥發(fā)生率，但可能不會降低周邊組術(shù)后炎癥發(fā)生率。骨科手術(shù)圍術(shù)期抗菌藥物使用以二代頭孢菌素（頭孢呋辛、頭孢美唑）為主（70%），其次為萬古霉素；其他抗菌藥物的使用占比相對較小。總體應(yīng)用抗菌藥物療程平均5.04 d；脊柱組應(yīng)用抗生素療程最長（7.20 d），上肢組療程最短（2.92 d）；其他部位為髖部組（3.87 d），腿部組（3.51 d），足踝部組（3.09 d）。結(jié)論 骨科不同部位Ⅰ類切口的患者在發(fā)病年齡、炎癥發(fā)生率、抗生素選擇及應(yīng)用療程方面存在明顯差異，針對性地使用抗菌藥物可促進(jìn)骨科Ⅰ類切口手術(shù)患者個體化用藥的合理性。

Objective To analyze the influence factors of post-operative inflammation of type I incision in orthopedic department from October 2016 to October 2018 in General Hospital of Northern Theater Command of PLA. The selection of antibacterial agents in different operative areas and the course of their application were retrospectively analyzed to provide suggestions for individual clinical use of antibacterial agents. Methods The selected research objects were counted and analyzed by Excel 2010 and SPSS 20.0 software. Results The incidence of spine and hip is later than other parts of the population. Upper limbs, legs, ankles and other parts of the male onset age earlier. The incidence of spinal inflammation (41.08%) was higher than that of the peripheral group (15.50%). There was no difference in postoperative inflammatory response rate between patients with and without diabetes. However, diabetes may increase postoperative inflammatory response rate in peripheral groups. Antibiotic bone cement can reduce inflammation rate in the spinal group, but may not reduce postoperative inflammation rate in the peripheral group. Second generation cephalosporin (cefuroxime, cefmetazole) was the main antibiotic used in perioperative period of orthopedic surgery (70%), followed by vancomycin. The use of other antimicrobials is relatively small. The average course of antibiotic application was 5.04 days. The course of antibiotics was longest in the spine group (7.20 days), and shortest in the upper limbs group (2.92 days). The other parts were the hip group (3.87 days), the leg group (3.51 days) and the ankle group (3.09 days). Conclusion The incidence of inflammation varies from site to site, and the efficacy of drugs varies from site to site. So, the rationality of drug use of the patients of type I incision of orthopedic could be promoted by the targeted application of antibacterial agents.

R982