奈替米星配伍甲硝唑治疗及预防阑尾炎及阑尾术后感染

Effects of netilmicin in combination with metronidazole in treatment of appendicitis and the prophylaxis of wound infection after appendectomy

目的 :观察奈替米星 (Net)配伍甲硝唑 (Met)治疗阑尾炎及预防阑尾术后感染的效果及 Net在阑尾组织中的分布。方法 :确诊阑尾炎病人给予 Net(0 .3g,iv gtt,qd) /Met(0 .5 g,iv gtt,tid) 2～ 7d保守治疗或阑尾切除手术病人术前 1次及术后 2 d应用 Net/Met预防阑尾术后感染。结果 :14例阑尾炎保守治疗有效率为 6 4.3% (9/14)。 5 2例阑尾切除术总手术感染率为 1.9% (1/5 2 )。 2 1例阑尾组织 Net浓度分别为 (3.91± 2 .0 3)︼g/g(0 .5～ 2 h)、(1.2 1± 0 .6 8)︼g/g(2～ 4h)及 (0 .86± 0 .5 3)︼g/g(4～ 6 h) ,达到有效治疗浓度 ,在组织中有较长的滞留时间。本实验过程中未见肝、肾功能及听力损害。结论 :Net对阑尾炎的保守治疗及预防阑尾切除术后感染具有良好的效果 ,应用安全。

AIM: To explore the effects of netilmicin (Net) in the treatment of appendicitis and the prophylaxis of wound infection after appendectomy, and investigate its penetration into appendix tissue. METHODS: Fourteen patients with appendicitis were administered Net 0 3 g iv gtt qd in combination with metronidazole 0 5 g iv gtt bid over 2-7 d for conservative treatment. Fifty two patients who underwent appendectomy were given the above dosage regimen once preoperation and 2 d postoperation, respectively. Blood samples and appendix tissues were obtained during operation. RESULTS: 64 3% (9/14) of appendicitis patients with conservative treatment was cured. The wound infection rate after appendectomy was 1 92% (1/52). The Net levels in the appendix tissues of 21 patients were (3 91±2 03) μg/g over 0 5-2 h,(1 21±0 68) μg/g over 2-4 h and (0 86±0 53) μg/g over 4-6 h, respectively. No adverse effects on hepatic, nephritic and hearing functions were found. CONCLUSION: Net appears to be effective and safe for the treatment of appendicitis and the prophylaxis of the wound infection after appendectomy.