蟾酥注射液联合抗生素治疗细菌性肝脓肿的临床观察

Clinical observation of venenum bufonis combined with antibiotics in the treatment of bacterial liver abscess

目的 探讨蟾酥注射液联合抗生素治疗细菌性肝脓肿的疗效.方法 收集细菌性肝脓肿患者60例,所有患者在B超引导下行经皮肝穿刺腔内抽脓术,采用随机数字表法将60例患者分为两组,每组30例.对照组给予抗生素抗感染治疗,观察组在常规抗生素治疗的基础上加用蟾酥注射液静脉滴注,1次/d,连用7d.监测两组疗效、体温、血常规、降钙素原等多个项目变化.结果 观察组总有效率显著高于对照组（96.7％比80.0％,χ^2=4.043,P=0.044）.观察组体温恢复正常时间[（5.67±2.16）d比（7.00±1.41）d]、白细胞恢复正常时间[（7.83±2.32）d比（9.82±1.94）d]、降钙素原恢复时间[（7.00±1.67）d比（9.00±1.41）d]、症状消失时间[（5.17±1.72）d比（7.50±1.87）d]、脓肿消失时间[（12.00±3.41）d比（16.00±2.37）d]均短于对照组（t=-2.601、-2.890、-2.236、-2.248、-2.362,P=0.026、0.016、0.049、0.044、0.041）.结论 蟾酥注射液联合抗生素治疗细菌性肝脓肿可有效控制感染,提高治愈率,值得临床推广.

Objective To evaluate the clinical effect of venenum bufonis combined with antibiotics in the treatment of bacterial liver abscess .Methods 60 patients with bacterial liver abscess were enrolled ,and all patients took percutaneous transhepatic puncture guided by ultrasound .They were randomly divided into two groups according to the digital table ,30 cases in each group .The control group received antibiotics treatment ,and the treatment group received venenum bufonis plus antibiotics intravenous drip ,once daily ,one course of treatment lasted seven days .The body temperature , blood routine , procalcitonin and other project changes of the two groups were detected .Results Compared with the control group,the effective rate of the treatment group was higher （96.7% vs.80.0%,χ^2 =4.043,P=0.044）.In the treatment group,the time of body temperature returning to normal [（7.00 ±1.67）d vs. （9.00 ±1.41）d],leukocyte recovery time [（7.83 ±2.32） d vs.（9.82 ±1.94） d],procalcitonin recovery time [（7.00 ±1.67）d vs.（9.00 ±1.41）d],symptom disappearance time [（5.17 ±1.72）d vs.（7.50 ±1.87）d],disap-pearance time of abscess[（12.00 ±3.41）d vs.（16.00 ±2.37）d]were shorter than those in the control group（t=-2.601,-2.890,-2.236,-2.248,-2.362,P=0.026,0.016,0.049,0.044,0.041）.Conclusion Venenum bufonis combined with antibiotics can significantly increase the curative rate and accelerate infection control , there-fore,it is worthy of popularizing in clinical practice .