肺癌根治术围术期使用不同剂量头孢噻肟预防术后感染的效果观察

Observation on the Effect of Cefotaxime with Different Doses in Periopration Period on the Prevention of Postoperative Infection of Lung Cancer Resection

目的:观察肺癌根治术围术期使用不同剂量头孢噻肟预防术后感染的疗效和安全性。方法:回顾性分析61例接受肺癌根治术治疗的非小细胞肺癌患者资料,按用药剂量的不同分为头孢噻肟2 g组(26例)和头孢噻肟4 g组(35例)。头孢噻肟2 g组患者于术前30 min给予注射用头孢噻肟钠2 g,加入0.9%氯化钠注射液100 ml中静脉滴注,如手术时间超过3 h,术中静脉滴注头孢噻肟2 g,术后再次静脉滴注头孢噻肟2 g,术前后用药时间需间隔12 h,用药总时间不超过48 h。头孢噻肟4 g组患者给予注射用头孢噻肟钠4 g(用法同头孢噻肟2 g组)。观察两组患者感染率,术前后白细胞、血红蛋白、白蛋白水平及不良反应发生情况。结果:两组患者感染率比较,差异无统计学意义(P>0.05)。两组患者术后白细胞、血红蛋白、白蛋白水平均显著低于同组治疗前,差异均有统计学意义(P<0.05),但两组间比较差异无统计学意义(P>0.05)。两组患者用药期间均未见明显不良反应发生。结论:非小细胞肺癌患者在肺癌根治术围术期给予小剂量头孢噻肟可达到较好的预防术后感染的效果,安全性较好,符合抗菌药物合理应用的原则。

OBJECTIVE：To observe the effecacy and safety of using cefotaxime using different doses in perioprative period on the prevention of postoperative infection of lung cancer resection. METHODS：61 patients with non-small cell lung cancer who received lung cancer resection were retrospectively analyzed divided into cefotaxime 2 g group（26 cases）and cefotaxime 4 g group（35 cases）according to dosage. Cefotaxime 2 g group was treated with Cefotaxime for injetion 2 g 30 min before operation,adding into 0.9% sodium chloride injection 100 ml,by intravenous infusion,if the operation time was more than 3 h,cefotaxime 2 g was intravenously infused during operation and cefotaxime 2 g was intravenously infused after operation,interval of 12 h was required for preoperative and postoperative medication time and the total medication time was no more than 48 h. Cefotaxime 4 g group was treated with Cefotaxime for injection 4 g（the usage was the same as cefotaxime 2 g group）. Leukocyte,hemoglobin,albumin,infection rate and incidence of adverse reactions in 2 groups before and after operation were observed. RESULTS：There was no significant difference in the infection rates between 2 groups（P〉0.05）. Leukocyte,hemoglobin and albumin in 2 groups were significantly lower than before,the differences were statistically significant（P〈0.05）,however,there was no significant difference between 2 groups（P〉0.05）. There were no obvious adverse reactions during treatment. CONCLUSIONS：Small dose of cefotaxime has good prevention effect on the postoperative infection of non-small cell lung cancer,with good safety,which meets the principles of rational use of antibiotics.