胃部灌洗降低患者内镜下黏膜剥离术后感染风险

Gastric irrigation decreases the risk of nosocomial infection in patients who underwent endoscopic submucosal dissection

目的探讨内镜下黏膜剥离术(endoscopic submucosal dissection,ESD)术前胃部灌洗对患者术后胃部细菌菌落数的影响,建立降低患者术后感染风险的策略。方法选取200例行胃部ESD的患者,随机分为清洁组和常规组,各100例,清洁组术前使用2 L生理盐水灌洗胃部,常规组术前未做胃部灌洗处理。取患者的胃液于术前、术后进行细菌培养。结果常规组、清洁组术后第1天胃液细菌数的平均对数值分别为5.16±0.71、1.92±0.85,差异有统计学意义(P<0.05);常规组患者术后第1天体温及外周血白细胞计数、C反应蛋白均高于清洁组,差异有统计学意义(P<0.05)。结论 ESD前胃部灌洗,可以有效降低患者术后胃部细菌菌落数,减少患者术后感染的风险。

Objective To investigate the effect of gastric irrigation before endoscopic submucosal dissection（ESD）on bacterial counts in stomach of the patients after ESD and provide prevention of nosocomial infection. Methods Two hundred subjects who underwent ESD were randomly divided into two groups（100 patients in each group）： the clean group（ irrigation with 2 L saline solution before ESD） and the regular group（ no irrigation）. The gastric juice was collected and cultured before and after ESD. Results The mean log bacterial count of the post-gastric irrigation gastric juice on the first postoperative day was 5. 16 ± 0. 71 in regular group and 1. 92 ± 0. 85 in clean group,there was significant between two groups（ P〈0. 05）. The white blood cells（ WBC） count,the C-reactive protein（ CRP） and the body temperature of the patients on the first postoperative day in the regular group were higher than that in the clean group（P〈0. 05）. Conclusion Pre-ESD gastric irrigation with saline solution is effective for decreasing bacterial counts in stomach of the patients and suppressing infection after the ESD procedure.