五水头孢唑林钠对腹部手术后早期炎性肠梗阻患者胃肠功能与电活动干预作用的临床观察

Effects of cefazolin sodium pentahydrate on gastrointestinal function and electrical activity in patients with early postoperative inflammatory bowel obstruction after abdominal operation

目的观察五水头孢唑林钠对腹部手术后早期炎性肠梗阻患者胃肠功能与电活动的干预作用。方法选取2014年4月至2016年4月在南京市第二医院普外科接受腹部手术后出现早期炎性肠梗阻患者86例，采用随机数字表法分为对照组和观察组，各43例，2组均采用禁食、补液、持续胃肠减压，保持水／电解质平衡等常规疗法，对照组抗感染采用头孢硫脒静脉滴注，观察组抗感染给予五水头孢唑林钠静脉滴注，2组抗感染剂量均为1．0g／次，1次／8h，疗程7d。观察2组患者肠鸣音恢复时间、首次排气时间、治疗前后血清肿瘤坏死因子α（TNF-α）和高敏C反应蛋白（hs-CRP）水平；检测治疗前及治疗24、48h后胃肠电图，比较平均慢波主频率和峰值幅度。结果观察组肠鸣音恢复时间和排气恢复时间均短于对照组，差异均有统计学意义[（27±3）h比（37±3）h、（41±10）h比（55±10）h]（均P〈0．05）。治疗后，观察组与对照组血清TNF-α、hs-CRP水平均较治疗前明显下降，差异均有统计学意义[TNF-α：（1．11±0．16）ng／L比（2．12±0．65）ng／L、（1．16±0．14）ng／L比（3．41±0．59）ng／L；hs-CRP：（5．8±2．1）mg／L比（37．7±5．6）mg／L、（6．2±3．4）mg／L比（39．3±5．0）mg／L]（均P〈0．01）。治疗24、48h后，观察组胃小弯、胃窦、升结肠和降结肠各部位的胃肠电图平均慢波主频率及峰值幅度均明显高于对照组，差异均有统计学意义（均P〈0．05）。结论五水头孢唑林钠可改善腹部手术后早期炎性肠梗阻患者的胃肠功能与电活动。

Objective To observe effects of cefazolin sodium pentahydrate on gastrointestinal function and electrical activity in patients with early postoperative inflammatory small bowel obstruction. Methods A total of 86 patients with early postoperative inflammatory small bowel obstruction from April 2014 to April 2016 in the Second Hospital of Nanjing were randomly divided into observation group and control group, with 43 cases in each group. Both groups had routine treatments including strict fasting, fluid replacement, continuous gastrointestinal decompression to maintain water-electrolyte balance. The control group had anti-infection treatment with cefathiamidine; the observation group had intravenous administration of cefazolin sodium pentahydrate; 1.0 g/time, 1 time/8 h for 7 d. Bowel sound recovery time and anal exhaust recovery time were recorded. Levels of tumor necrosis factor α（TNF-α） and high sensitive C-reactive protein（hs-CRP） were tested. Electrogastroenter- ography was performed before and 24, 48 h after treatment; main frequency and peak amplitude were analyzed. Results Bowel sound recovery time and anal exhaust recovery time in observation group were significantly shorter than those in controlgroup[（27±3）hvs （37±3）h, （41±10）hvs （55±10）h]（P〈0. 05）. Levels of TNF-α and hs-CRP significantly decreased after 7 d of treatment compared to those before treatment in both groups [TNF-α：（1.11±0.16）ng/Lvs （2. 12±0.65）ng/L, （1.16±0.14）ng/L vs （3.41 ±0.59）ng/L; hs-CRP： （5.8 ± 2. 1 ） mg/L vs （37.7 ± 5.6） mg/L, （6. 2 ± 3.4） mg/L vs （39. 3 ± 5. 0） mg/L ] （ P 〈 0. 01 ）. At 24, 48 h after treatment, main frequencies and peak amplitudes of electrogastroenterograms on lesser curvature of stomach, gastric antrum, ascending colon and descending colon in observation group were significantly higher than those in control group（P 〈 0.05 ）. Conclusion Cefazolin sodium pentahydrate can improve gastrointestinal function and electrical activity in patients with early postoperative inflammatory small bowel obstruction.