左氧氟沙星不同用药方法对急性化脓性阑尾炎术后切口感染及血清sICAM-1、IL-8、TNF-a的影响研究

Effects of different delivery methods of levofloxacin on postoperative incision infection and serum sICAM-1,IL-8,and TNF-a of patients with acute suppurative appendicitis

目的探讨左氧氟沙星不同用药方法对急性化脓性阑尾炎术后切口感染及血清可溶性粘附分子-1(sICAM-1)、白细胞介素-8(IL-8)、肿瘤坏死因子-a(TNF-a)的影响,为急性化脓性阑尾炎的围术期用药提供参考。方法选取2014年1月-2015年12月在医院住院拟行手术治疗200例急性化脓性阑尾炎患者,随机分为A组与B组,每组100例,行阑尾切除术,在术前30min开始给予0.4g左氧氟沙星静脉滴注,A组术后0.2g/次、2次/d静脉滴注,B组术后0.4g/次/d静脉滴注,常规术用药3d,观察术后切口感染发生情况,术前及术后3d时血清sICAM-1、IL-8、TNF-a水平。结果术后A组出现18例切口感染,B组出现8例切口感染,感染率分别为18.00%、8.00%,比较差异有统计学意义(P<0.05);两组sICAM-1、IL-8、TNF-a术后明显下降(P<0.05),B组较A组下降更为明显(P<0.05)。结论急性化脓性阑尾炎患者围术期左氧氟沙星用药方法对术后切口及血清sICAM-1、IL-8、TNF-a存在一定影响,术前30min单次联合术后0.4g/次/d静脉滴注相对于术前30min单次联合术后0.2g/次、2次/d用药在降低切口感染方面更有优势。

OBJECTIVE To explore the effects of different delivery methods of levofloxacin on postoperative incision infection and serum soluble adhesion molecule‐1 （sICAM‐1） ,interleukin‐8 （IL‐8） ,and tumor necrosis factor‐a （TNF‐a） of patients with acute suppurative appendicitis so as to provide guidance for use of antibiotics during peri‐operative period .METHODS A total of 200 patients with acute suppurative appendicitis who intended to receive surgical procedures in the hospital from Jan 2014 to Dec 2015 were enrolled in the study and randomly divided into the group A and the group B ,with 100 cases in each .All of the participants underwent the appendectomy and were given intravenous drip of 0 .4g levofloxacin by staring from 30 min before the surgery ,the group A was trea‐ted with postoperative 0 .2g per time ,2 times per day of intravenous drip ,while the group B was given postopera‐tive 0 .4g per time per day of intravenous drip ,and the length of conventional medication was 3 days .The inci‐dence of postoperative incision infection and the levels of serum sICAM‐1 ,IL‐8 ,and TNF‐a before the surgery and after the surgery for 3 days were observed .RESULTS The postoperative incision infection occurred in 18 cases in the group A and 8 cases in the group B;the infection rate was 18 .00% in the group A ,8 .00% in the group B , and there was significant difference （P〈0 .05） .The levels of sICAM‐1 ,IL‐8 ,and TNF‐a of the two groups de‐clined remarkably after the surgery （P〈0 .05） and declined more remarkably in the group B than in the group A （P〈0 .05） .CONCLUSION The perioperative delivery method of levofloxacin has certain impact on the incidence of postoperative incision infection and the levels of serum sICAM‐1 ,IL‐8 ,and TNF‐a of the patients with acute sup‐purative appendicitis .The single time 30 min before the surgery combined with postoperative 0 .4g per time per day of intravenous drip is superior to the single time 30 min before the surgery combined with postoperative 0 .2g per time ,2 times per day in reducing the incidence of the incision infection .