原发性肝癌TACE术后预防性抗生素应用价值研究

Prophylactic use of antibiotics after interventional procedures for primary hepatocellular carcinoma: its clinical significance

目的探讨原发性肝癌患者介入术后预防性应用抗生素的作用。方法对94例原发性肝癌患者行101例次TACE治疗。术前采用信封法随机分为A组和B组,A组54例介入术后应用头孢呋辛(2.25 g,2次/d)3 d,B组45例介入术后不用抗生素。术后观察体温、外周血白细胞计数及体征1个月。对疑似感染病例行血培养检查。参照2001中华人民共和国卫生部颁发的《医院感染诊断标准》认定有无感染。比较两组术后感染率。结果 A组1例诊断为败血症,感染率1.8%(1/54)。B组1例诊断为败血症,感染率为2.2%(1/45)。两组术后感染率比较分析差异无统计学意义(P>0.05)。结论术前无感染高危因素的原发性肝癌患者TACE术后无需抗生素预防术后感染。

Objective To discuss the necessity of prophylactic use of antibiotics after interventional procedures for primary hepatocellular carcinoma （HCC）. Methods A total of 94 patients with HCC were enrolled in this study. A total of 101 times of transcatheter arterial chemoembolization （TACE） were performed in the patients. The patients were randomly divided into two groups. After the procedure, the patients in group A received cefuroxime （2.25 g, two times per day for three days）, while the patients in group B received no antibiotics. The patients were followed up for one month. Postoperative observations included body temperature, WBC count and patient＇s physical condition. Blood culture was performed when the patient was suspected of having infection. The infection rates were compared between the two groups.Results Septicemia occurred in one case of group A （1.8%） and in one case of group B（2.2%）. No statistically significant difference in the occurrence of infection existed between the two groups（P 〉 0.05）. Conclusion After interventional procedures for HCC, prophylactic use of antibiotics is not necessary for the patients who carries no high risk to infection before treatment.