急性化脓性阑尾炎围术期左氧氟沙星不同用药方案对术后切口感染的预防作用
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摘要
目的探讨急性化脓性阑尾炎围术期左氧氟沙星不同用药方案对切口感染的预防效果。方法方便选取2016年3月—2018年7月收治的92例急性化脓性阑尾炎患者,以随机数字表法分为对照组46例和观察组46例,均行阑尾切除术治疗,抗感染药均采用左氧氟沙星。观察组用药方案为术前30 min静脉滴注0.4 g+术后静脉滴注0.2 g/次,2次/d;对照组用药方案为术前30 min静脉滴注0.4 g+术后静脉滴注0.4 g/次,1次/d。观察两组术前、术后3 d炎性因子水平变化,术后切口换药次数、切口愈合时间、住院时间以及术后切口感染情况。结果术前两组炎性因子水平差异无统计学意义(P>0.05),术后均有下降,观察组术后3 d血清IL-8、IL-6、CRP水平均较对照组低,差异有统计学意义(P<0.05);观察组术后切口换药次数、切口愈合时间及住院时间与对照组对比,差异有统计学意义((t=5.587、3.610、3.472,P<0.05);观察组术后切口感染发生率为2.17%,同对照组13.04%对比,差异有统计学意义(χ~2=3.989,P<0.05)。结论以术前30 min静脉滴注0.4 g+术后静脉滴注0.2 g/次,2次/d方案使用左氧氟沙星,可有效降低急性化脓性阑尾炎患者术后切口感染发生风险,也能促进患者康复,值得推广。
Objective To investigate the preventive effect of different administration regimens of levofloxacin in patients with acute suppurative appendicitis on wound infection. Methods 92 patients with acute suppurative appendicitis admitted from March 2016 to July 2018 were convenient selection randomly divided into the control group(46 cases) and the observation group(46 cases). All patients underwent appendectomy. The anti-infective drugs were levofloxacin. The observation group was given intravenous infusion of 0.4 g+ for 30 min before operation, followed by intravenous infusion of 0.2 g/times,twice per day. The control group was given intravenously for 30 min before surgery for 0.4 g/time after intravenous infusion,1 time/d. The changes of inflammatory factors in the two groups before and after surgery were observed. The number of incision dressings, wound healing time, hospitalization time and postoperative wound infection were observed. Results There was no significant difference in the levels of inflammatory factors between the two groups(P>0.05). The levels of serum IL-8,IL-6 and CRP in the observation group were lower than those in the control group. Statistical significance(P <0.05); the number of incision dressing changes, incision healing time and hospitalization time in the observation group were significantly different from those in the control group(t=5.587, 3.610, 3.472, P<0.05); observation group of the incidence of postoperative incision infection was 2.17%, compared with 13.04% in the control group. The difference was statistically significant(χ~2=3.989, P<0.05). Conclusion Intravenous infusion of 0.4 g+ before 30 min before surgery, intravenous infusion of 0.2 g/times,2 times/d, using levofloxacin, which can effectively reduce the risk of postoperative wound infection in patients with acute suppurative appendicitis, can also promote rehabilitation of patients, it is worth promoting.
Objective To investigate the preventive effect of different administration regimens of levofloxacin in patients with acute suppurative appendicitis on wound infection. Methods 92 patients with acute suppurative appendicitis admitted from March 2016 to July 2018 were convenient selection randomly divided into the control group(46 cases) and the observation group(46 cases). All patients underwent appendectomy. The anti-infective drugs were levofloxacin. The observation group was given intravenous infusion of 0.4 g+ for 30 min before operation, followed by intravenous infusion of 0.2 g/times,twice per day. The control group was given intravenously for 30 min before surgery for 0.4 g/time after intravenous infusion,1 time/d. The changes of inflammatory factors in the two groups before and after surgery were observed. The number of incision dressings, wound healing time, hospitalization time and postoperative wound infection were observed. Results There was no significant difference in the levels of inflammatory factors between the two groups(P>0.05). The levels of serum IL-8,IL-6 and CRP in the observation group were lower than those in the control group. Statistical significance(P <0.05); the number of incision dressing changes, incision healing time and hospitalization time in the observation group were significantly different from those in the control group(t=5.587, 3.610, 3.472, P<0.05); observation group of the incidence of postoperative incision infection was 2.17%, compared with 13.04% in the control group. The difference was statistically significant(χ~2=3.989, P<0.05). Conclusion Intravenous infusion of 0.4 g+ before 30 min before surgery, intravenous infusion of 0.2 g/times,2 times/d, using levofloxacin, which can effectively reduce the risk of postoperative wound infection in patients with acute suppurative appendicitis, can also promote rehabilitation of patients, it is worth promoting.
引文
[1]Sheridan Alison D,Ehrlich Lauren,Morotti Raffaella A, et al.Sonographic Distinction Between Acute Suppurative Appendicitis and Viral Appendiceal Lymphoid Hyperplasia("Pink Appendix'')With Pathological Correlation[J].Ultrasound quarterly,2015,31(2):95-98.
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[3]付钧.左氧氟沙星、甲硝唑联合薄芝糖肽在化脓性阑尾炎术后感染防治中的应用[J].现代诊断与治疗,2015,25(5):1008-1009.
[4]张一帆.左氧氟沙星联合碘伏对急性阑尾炎患者术后切口愈合及感染发生率的影响[J].河南医学研究,2018,27(1):155-156.
[5]张松静,马祥祥,张科,等.奥曲肽联合硫酸奈替米星预防化脓性阑尾炎术后感染及对患者Th17/Treg失衡的影响[J].中国生化药物杂志,2017,17(4):351-353.
[6]杨友石.化脓性阑尾炎术后切口感染临床观察与预防[J].医学信息,2015,31(25):197.
[7]于敏.左氧氟沙星配伍甲硝唑治疗急性化脓性阑尾炎的疗效分析[J].中国医药指南,2015,13(2):192-193.
[8]陈水年.左氧氟沙星配伍甲硝唑治疗急性化脓性阑尾炎的疗效观察[J].临床医学工程,2017,24(6):815-816.
[9]孟钰.甲硝唑联合左氧氟沙星预防急性阑尾炎术后切口感染的临床观察[J].北方药学,2018,15(3):66-67.
[10]许震,孙生安,刘帅峰,等.左氧氟沙星不同用药方法对急性化脓性阑尾炎术后切口感染及血清sICAM-1、IL-8、TNF-a的影响研究[J].中华医院感染学杂志,2016,26(22):5169-5171.
[2]施圣强,张贵阳.急性化脓性阑尾炎患者切口感染因素分析及预防措施研究[J].浙江创伤外科,2015,24(2):259-260.
[3]付钧.左氧氟沙星、甲硝唑联合薄芝糖肽在化脓性阑尾炎术后感染防治中的应用[J].现代诊断与治疗,2015,25(5):1008-1009.
[4]张一帆.左氧氟沙星联合碘伏对急性阑尾炎患者术后切口愈合及感染发生率的影响[J].河南医学研究,2018,27(1):155-156.
[5]张松静,马祥祥,张科,等.奥曲肽联合硫酸奈替米星预防化脓性阑尾炎术后感染及对患者Th17/Treg失衡的影响[J].中国生化药物杂志,2017,17(4):351-353.
[6]杨友石.化脓性阑尾炎术后切口感染临床观察与预防[J].医学信息,2015,31(25):197.
[7]于敏.左氧氟沙星配伍甲硝唑治疗急性化脓性阑尾炎的疗效分析[J].中国医药指南,2015,13(2):192-193.
[8]陈水年.左氧氟沙星配伍甲硝唑治疗急性化脓性阑尾炎的疗效观察[J].临床医学工程,2017,24(6):815-816.
[9]孟钰.甲硝唑联合左氧氟沙星预防急性阑尾炎术后切口感染的临床观察[J].北方药学,2018,15(3):66-67.
[10]许震,孙生安,刘帅峰,等.左氧氟沙星不同用药方法对急性化脓性阑尾炎术后切口感染及血清sICAM-1、IL-8、TNF-a的影响研究[J].中华医院感染学杂志,2016,26(22):5169-5171.