摘要
目的观察万古霉素结合头孢曲松钠治疗肝癌手术并发复杂性腹腔感染的效果。方法回顾性选取2020年1月-2021年12月在河北北方学院附属第一医院接受肝部分切除术后并发复杂性腹腔感染的96例肝癌患者为对象,所有患者均为革兰阳性菌感染,均接受经皮穿刺引流和抗生素治疗,根据抗菌治疗中是否使用万古霉素将其分为观察组(使用万古霉素,n=48)和对照组(未使用万古霉素,n=48)。比较2组疗效、细菌清除率、住院时间以及白细胞计数(WBC)、降钙素原(PCT)、C反应蛋白(CRP)水平的差异。结果观察组疗程结束后总有效率为97.92%(47/48),高于对照组的89.58%(43/48),但差异无统计学意义(χ^(2)=2.844,P=0.092)。治疗前2组WBC、PCT、CRP水平比较,差异无统计学意义(t=0.174、0.348、0.602,P均>0.05);治疗7、14 d后2组WBC、PCT、CRP水平较治疗前明显降低,差异均有统计学意义(P均<0.05);且观察组治疗7、14 d后WBC、PCT、CRP水平低于对照组,差异均有统计学意义(t=9.130、12.200、7.764,7.293、9.956、6.792;P均<0.05)。观察组疗程结束后细菌清除率为93.75%(45/48),高于对照组的83.33%(40/48),但差异无统计学意义(χ^(2)=2.567,P=0.109)。观察组住院时间为(26.45±3.27)d,短于对照组的(30.41±4.02)d,差异有统计学意义(χ^(2)=5.294,P<0.05)。结论万古霉素结合头孢曲松钠治疗肝癌手术并发复杂性腹腔感染可有效控制感染,降低感染相关指标水平,促进术后恢复。
Objective To observe the effect of vancomycin combined with ceftriaxone sodium in the treatment of complicated abdominal infection after liver cancer surgery.Methods Retrospectively selected 96 liver cancer patients with complicated abdominal infection after partial hepatectomy in the First Affiliated Hospital of Hebei North University from January 2020 to December 2021.All patients were infected with gram-positive bacteria,and all received percutaneous puncture drainage and antibiotic treatment.According to whether vancomycin was used in antibiotic treatment,they were divided into observation group(using vancomycin,n=48)and control group(not using vancomycin,n=48).The difference of efficacy,bacterial clearance rate,hospital stay and white blood cell count(WBC),procalcitonin(PCT),C-reactive protein(CRP)between the two groups were compared.Results After treatment,the total effective rate of the observation group was 97.92%(47/48),higher than that of the control group[(89.58%(43/48)],but the difference was not statistically significant(χ^(2)=2.844,P=0.092).There was no significant difference in WBC,PCT and CRP levels between the two groups before treatment(t=0.174,0.348,0.602,all P>0.05);after 7 and 14 days of treatment,the levels of WBC,PCT and CRP in the two groups were significantly lower than those before treatment,the differences were statistically significant(all P<0.05);the levels of WBC,PCT and CRP in the observation group were lower than those in the control group after 7 and 14 days treatment;the differences were statistically significant(t=9.130,12.200,7.764;7.293,9.956,6.792;all P<0.05).The bacterial clearance rate of the observation group was 93.75%(45/48)after the end of the treatment course,which was higher than 83.33%(40/48)of the control group,but the difference was not statistically significant(χ^(2)=2.567,P=0.109).The hospital stay in the observation group was(26.45±3.27)d,which was shorter than that in the control group[(30.41±4.02)d],and the difference was statistically significant(χ^(2)=5.294,P<0.05).Conclusion Vancomycin combined with ceftriaxone sodium in the treatment of complicated abdominal infection after liver cancer surgery could effectively control infection,reduce the level of infection-related indicators,and promote postoperative recovery.
作者
刘云宁
汤建华
姜爱雯
褚明娟
侯霞
朱建新
LIU Yunning;TANG Jianhua;JIANG Aiwen;CHU Mingjuan;HOU Xia;ZHU Jianxin(Department of Pharmacy,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)
出处
《热带医学杂志》
CAS
2023年第9期1266-1269,1298,共5页
Journal of Tropical Medicine
基金
河北省2021年度医学科学研究计划(20211198)
关键词
万古霉素
头孢曲松钠
肝癌
复杂性腹腔感染
Vancomycin
Ceftriaxone sodium
Liver cancer
Complex abdominal infection
作者简介
刘云宁(1982-),男,硕士研究生,主管药师,E-mail:liuyunning1120@163.com
