左奥硝唑氯化钠注射液治疗胆囊结石合并胆总管结石术后患者的临床效果

Clinical effect of levornidazole sodium chloride injection on patients after cholecysto-choledocholithiasis surgery

目的评价左奥硝唑氯化钠注射液治疗胆囊结石合并胆总管结石(CCWC)术后患者的临床效果。方法收集2015年8月至2017年6月中国医科大学附属第四医院收治的120例CCWC患者的病历资料。依据术后用药不同分为观察组和对照组,各60例。2组患者均行腹腔镜胆囊切除术联合腹腔镜胆总管探查术,术中抽取胆汁做细菌培养。观察组术后静脉滴注头孢3代+左奥硝唑氯化钠注射液,对照组术后静脉滴注头孢3代+奥硝唑氯化钠注射液,给药剂量均为0.5 g/次,2次/d,术后3 d为试验结点。比较2组患者用药后的临床疗效、细菌学疗效及不良反应发生率。结果治疗后,观察组白细胞计数和中性粒细胞百分比正常比例高于对照组[95.0%(57/60)比81.7%(49/60)、90.0%(54/60)比75.0%(45/60)],差异均有统计学意义(均P<0.05)。2组间厌氧菌感染阳性率差异无统计学意义(P>0.05),用药后观察组清除率高于对照组,但2组间差异无统计学意义(P>0.05)。观察组头晕、嗜睡不良反应发生率均低于对照组[0.0%(0/60)比13.3%(8/60)、0.0%(0/60)比6.7%(4/60)],差异均有统计学意义(均P<0.05)。结论 CCWC术后应用左奥硝唑氯化钠注射液治疗,患者恢复快,药物不良反应少,疗效可靠。

Objective To evaluate the effect of levornidazole sodium chloride injection on patients after surgery of cholecystolithiasis complicated with choledocholithiasis （CCWC）. Methods Clinical data of 120 patients with CCWC who had laparoscopic cholecystectomy combined with common bile duct exploration from August 2015 to June 2017 in the Fourth Affiliated Hospital of China Medical University were retrospectively analyzed; bile was extracted during operation for bacterial culture. The observation group（ 60 cases） had intravenous administration of the 3rd generation cephalosporins plus levonaidazole sodium chloride injection and the control group（ 60 cases） had intravenous administration of the 3rd generation cephalosporins plus ornidazole sodium chloride injection after operation; 0. 5 g/time, 2 times/d, lasting for 3 d. Clinical efficacy, bacteriological efficacy and incidence of adverse reactions were analyzed. Results Normal ratios of leukocyte count and neutrophil percentage in observation group were significantly higher than those in control group after treatment[95. 0% （57/60） vs 81.7% （49/60）, 90.0% （54/60） vs 75.0% （45/60） ] （P 〈 0. 05 ）. Positive rate of anaerobic infection showed no significant difference between groups （ P 〉 0. 05 ）. After medication, clearance rate in observation group was higher than that in control group but the difference was not significant （P 〉 0. 05 ）. Incidences of dizziness and drowsiness in observation group were significantly lower than those in control group[0. 0% （0/60） vs 13.3% （8/60）, 0. 0% （0/60） vs 6. 7% （4/60） ] （P 〈 0.05 ）. Conclusion Application of levornidazole sodium chloride injection can help promote recovery of patients with CCWC surgery with less adverse reaction.