左氧氟沙星联合甲硝唑预防腹腔镜阑尾切除术围术期感染98例效果观察

Clinical Observation of Levofloxacin Combined with Metronidazole for Preventing Perioperative Infection of Laparoscopic Appendectomy in 98 Cases

目的探讨左氧氟沙星联合甲硝唑对急性阑尾炎患者腹腔镜阑尾切除术(LA)围术期感染的预防效果。方法选择医院行LA的急性阑尾炎患者196例,采用随机数字表法分为对照组和观察组,各98例。对照组患者在术前0.5 h给予甲硝唑静脉滴注,术后继续用药3 d,观察组在此基础上术前0.5 h加用左氧氟沙星静脉滴注,术后继续3 d治疗。结果观察组术后住院时间、术后腹痛缓解时间、切口愈合时间短于对照组(P<0.05);术后1个月内,观察组相关感染发生率均较对照组低(P<0.05);术后第3天时,两组患者血清可溶性黏附分子-1(sICAM-1)、C反应蛋白(CRP)、白细胞介素6(IL-6)水平均较术前降低(P<0.05),且观察组低于对照组(P<0.05)。结论左氧氟沙星联合甲硝唑疗法对预防急性阑尾炎患者LA围术期感染效果显著,可降低术后感染发生风险,同时缓解炎性反应和应激反应,促进患者术后恢复,值得临床推广。

Objective To investigate the effect of levofloxacin combined with metronidazole in preventing perioperative infection of laparoscopic appendectomy（ LA） in patients with acute appendicitis. Methods Totally 196 patients with acute appendicitis underwent LA in our hospital were selected and randomly divided into the control group and the observation group, 98 cases in each group. The control group was treated with intravenous drip of metronidazole at 0. 5 h before operation,and medication lasted for 3 d after operation. On the basis,the observation group was given intravenous drip of levofloxacin at 0. 5 h before operation, and medication lasted for 3 d after operation.Results After the operation,the time of hospitalization,the relieving time of abdominal pain and the healing time of the incision in the observation group were shorter than those in the control group（ P〈0. 05）. Within 1 month after the operation,the incidence rate of related infection in the observation group was lower than that of the control group（ P〈0. 05）. On the third day after operation, the levels of serum s ICAM-1,CRP and IL-6 in the two groups were lower than those before the operation（ P〈0. 05）,and those of the observation group were lower than those of the control group（ P〈0. 05）. Conclusion Levofloxacin combined with metronidazole has good effect on preventing perioperative infection of LA in patients with acute appendicitis,it can reduce the risk of postoperative infection and alleviate the inflammatory and stress reactions. It also can promote the recovery of patients after operation,and it is worthy of clinical promotion.