应用左氧氟沙星针剂与片剂序贯疗法预防女性压力性尿失禁围手术期感染

Prevention of peri-operative infection with levofloxacin in female patients undergoing surgery for stress urinary incontinence

目的观察左氧氟沙星（可乐必妥）针剂与片剂序贯疗法预防女性压力性尿失禁手术围手术期感染的临床疗效和安全性。方法对象为85例因压力性尿失禁而接受尿道中段悬吊带术患者，平均年龄58岁，平均体重63kg。对其中24例切除子宫患者予以左氧氟沙星500mg，每日1次，静脉滴注；序贯片剂500mg，每日1次口服。对61例单纯行悬吊带术者予以左氧氟沙星500mg单剂量静脉滴注，序贯口服片剂预防术后感染，观察临床有效性和不良反应。结果切除子宫患者平均静脉用药时间2．5d，序贯口服用药5．7d。单纯行吊带术患者单剂量静脉滴注后序贯片剂的平均治疗时间为3．2d。81例患者围手术期未出现感染，预防感染的有效率为95．3％，其中61例单纯行悬吊带术患者中无一例出现感染，预防感染的有效率为100％。全部患者中仅3例出现轻微胃肠道反应，2例出现皮疹，副反应发生率为5．9％。结论左氧氟沙星针剂与片剂序贯疗法预防妇科泌尿手术围手术期感染有效率高、安全性好。

Objective To investigate the effect and safety of sequential therapy of levofloxacin in prevention of peri-operative infection among female patients undergoing surgery for stress urinary incontinence （SUI）. Methods 85 female SUI patients, aged 58, with the average body weight of 63 g, underwent transvaginal tape （TVT） procedure. Levofloxacin 500 mg was given to 24 of the 85 patients who underwent simultaneous hysterectomy by intravenous injection since 1 day after the operation once a day and then given orally once a day for 4 - 8 days when the condition was improved. And levofloxacin 500 mg was given by intravenous injection to 61 of the 85 patients who were to underwent simple TVT 30 min before the operation and then was given orally 500 mg once a day for 4 days. The clinical efficacy and side reaction were observed. Resnits The average duration of intravenous injection of levofloxacin in the patients who underwent hysterectomy was 2.5 d, and the duration of oral administration of levofloxacin was 5.7 d. The duration of oral administration of levofloxacin in the patients who underwent simple TVT was 3.2 d. No infection was seen in 85 patients with an efficient rate of 95.3%. No infection was found in all the 61 patients who underwent simple TVT with an efficient prevention rate of 100%. The overall side reaction rate was 5. 9%. Only 3 patients showed mild gastroenterological reaction and 2 patients showed rashes. Conclusion Sequential therapy of levofloxacin is effective and safe in prevention of peri-operative infection in female patients undergoing surgery for stress urinary incontinence.