甘露聚糖肽注射液对腹外疝患者围手术期免疫功能的影响

Influence of Mannatide Injection on Immunity Index in the Patients with Abdominal External Hernia at Peri Operation Period

目的:探讨腹外疝手术应用甘露聚糖肽注射液预防手术感染的临床效果。方法:将172例腹外疝手术患者随机分为治疗组和对照组。治疗组术前1小时及术后6天静脉点滴甘露聚糖肽注射液,10mg/次,1天/次。对照组于术前1小时及术后6天静脉点滴相同剂量的生理盐水。两组在治疗过程中均不使用抗菌药物。结果:两组患者最高体温和退热时间均具有统计学差异(P=0.049,P=0.042)。治疗组患者感染并发症发生率3.49%。对照组患者感染并发症发生率为5.84%,两组感染并发症发生率比较无统计学意义(χ2=0.52,P=0.47)。两组患者术前2天、术毕CD3+、CD4+、CD4+/CD8+、NK细胞等各项指标差异无统计学意义(P>0.05),两组术毕时较术前各项免疫指标均明显降低(P<0.05)。治疗组术后第4、第7天CD3+、CD4+、CD4+/CD8+、NK细胞等各项指标较术前明显升高,对照组术后4天各项指标较术前略有下降趋势但未见统计差异(P>0.05),术后7天回到术前水平。两组术后各项免疫指标差异具有统计学意义(P<0.05)。治疗组患者术后7天临床总有效率(89.53%)明显高于对照组(83.72%),但两组比较无统计学差异(P=0.41,P=0.38)。治疗组患者平均住院时间为(3.07±1.95)天,较对照组显著缩短(P=0.015)。结论:甘露聚糖肽注射液能增强腹外疝患者机体免疫功能,不使用抗生素的情况下,能防止创口感染,减少其他感染并发症,值得在临床推广。

Objective：To observe the clinical effect of mannatide injection in preventing abdominal external hernia operation incision infection.Methods：172 patients were divided into treatment group（n=86）and control group（n=86） randomly,The patients in treatment group were administrated mannatide injection from one hour before operation to 6 days post-operation.The control group was only given the same dose of normal saline.The use of antibiotics were forbidden in two groups.Results：There were significant differences between two groups in terms of the highest temperature and time to defervescence（P=0.049,P=0.042.The incidence of infectious complications of treatment group and control group were 3.49%,5.84% respectively,but there were no significant differences between two groups（χ2=0.52,P=0.47）.There were no significant differences in the content of CD3＋,CD4＋,CD4＋/CD8＋,NK between the two groups immediately after operation（P0.05）.All of the immunity indexes of two groups were decreased significantly post-operation（P0.05）.There were significant differences at the forth postoperative day and the seventh postoperative day contrast with preoperation in terms of the content of CD3＋,CD4＋,CD4＋/CD8＋,NK of treatment group.Each immunity index of the control group decreased slightly 4 days post-operation compared with preoperative but there were no statistical differences in trends（P0.05）,They were back to the level of preoperation 7 days post-operation.There was statistical significant difference of the index between the two groups after operation.The clinical effects in treatment group（89.53%） were also higher than that of the control group（83.72%）,but there were no significant differences between two groups（P0.05）.The average hospitalization time of patients in the treatment group was（3.07±1.95） days,significantly shorter than those in control group（P=0.015）.Conclution： Without the use of antibiotics in case,mannatide injection can improve the immune function of the patients with abdominal external hernia,prevent wound infection,reduce the infection of other complications,which is worth promoting in clinical.