术前预防性应用头孢曲松钠对胃癌术后感染性并发症的影响

Effect of preoperative prophylactic application of ceftriaxone sodium on the prognosis of postoperative abdominal infection in patients with gastric cancer

目的探讨术前预防性应用头孢曲松钠对胃癌术后患者发生腹腔感染等并发症的影响。方法回顾性分析60例胃癌根治术术前预防性应用头孢曲松钠患者的临床资料(观察组)与60例胃癌根治术术前没有预防性应用头孢曲松钠患者的临床资料(对照组),分别比较术后第1天和第5天两组患者的白细胞(WBC)计数、C-反应蛋白(CRP)水平和体温变化情况;术后第5天患者腹腔感染、切口感染、肺部感染的发生率和细菌培养的阳性率。结果术后第5天,观察组患者细菌培养的阳性率(6.67%)低于对照组(23.33%),腹腔感染的发生率(6.67%)亦低于对照组(20.00%),差异均有统计学意义(P﹤0.05);两组患者切口感染和肺部感染的发生率比较,差异无统计学意义(P﹥0.05)。两组患者术后第5天WBC和CRP水平均低于术后第1天,且观察组患者术后第1天和第5天WBC、CRP水平均低于对照组,差异均有统计学意义(P﹤0.05)。术后第1天和第5天,观察组患者的平均体温均低于对照组,差异有统计学意义(P﹤0.05)。结论术前预防性应用头孢曲松钠可以减少胃癌术后患者腹腔感染等并发症的发生率。

Objective To investigate the effect of preoperative prophylactic application of ceftriaxone sodium on postoperative abdominal infection in patients with gastric cancer. Method Retrospective analysis for 60 cases of gastric cancer patients（study group） with, and another 60 cases（control group） without preoperative prophylactic application of ceftriaxone sodium before radical gastrectomy was performed. The levels of white blood cell count（WBC） and C-reactive protein（CRP） of the two groups of patients on the first day and fifth day after surgery were compared, at the same time the incidence of intra-abdominal infection, infection of incision, pulmonary infection and positive rate of bacterial culture five days after surgery were investigated. Result On fifth day, the positive rate of bacterial culture（6.67%） in study group was significantly lower than that in the control group（23.33%）（P〈0.05）. The incidence of intraabdominal infection in study group（6.67%） was also lower than that in the control group（20.00%）（P〈0.05）. The incidence of incision infection and pulmonary infection in study group were similar（P〉0.05）. The levels of WBC and CRP on the first and fifth day after surgery in the two groups were lower than before（P〈0.05）, and that of study group were lower compared with control group（P〈0.05）. The mean body temperature of the study group was lower than that of the control group on the first day and the fifth day after surgery（P〈0.05）. Conclusion Preoperative prophylactic application of ceftriaxone sodium can reduce the incidence of postoperative abdominal infection in patients with gastric cancer.