急性单纯性阑尾炎抗生素使用的策略及其价值的临床观察

Strategy and Value of Antibiotics Use in Acute Simple Appendicitis

目的:探讨对于急性单纯性阑尾炎患者抗生素使用策略及其临床价值。方法:选取2016年2月1日—2019年2月1日我院普外科所收治的60例急性单纯性阑尾炎患者,随机分成对照组(行阑尾切除手术治疗)和观察组(使用抗生素类的药物治疗),每组30例,比较治疗前后两组临床相关指标、临床疗效及并发症发生情况,比较治疗前后两组白细胞计数、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)水平。结果:观察组体温恢复正常时间、下床活动时间与住院天数均明显短于对照组(P<0.05),疼痛缓解所需时间两组无显著差异(P>0.05);对照组临床治愈率为93.33%(27/30),高于观察组76.67%(23/30)(P<0.05);观察组治疗后并发症发生率为6.67%(2/30),低于对照组的13.33%(4/30)(P<0.05);治疗前两组白细胞计数及炎性因子水平无差别(P>0.05),治疗1周后观察组白细胞计数、IL-6、TNF-α、CRP水平分别为(8.07±0.82)×109/L、(27.66±4.85)ng/mL、(1.48±0.33)mg/L、(60.54±12.87)mg/L,较对照组低[白细胞计数、IL-6、TNF-α、CRP水平分别为(10.14±0.96)×109/L、(49.78±5.37)ng/mL、(2.21±0.41)mg/L、(91.32±13.16)mg/L](P<0.05)。结论:对于急性单纯性阑尾炎的患者使用抗生素治疗,虽存在一定的复发倾向,但能有效改善患者临床相关指标及降低并发症发生率,减轻患者炎性反应。

Objective To explore the strategy and value of antibiotics use in patients with acute appendicitis.Methods Sixty patients with acute simple appendicitis admitted to our hospital from February 1st,2016 to February 1st,2019 were divided into control group(Surgical treatment)and observation group(treatment with antibiotics)according to the selected treatment plan,30 cases/group.The clinically relevant indicators,clinical efficacy and complications in two groups after treatment were compared,and the levels of white blood cell count and inflammatory factors(IL-6,TNF-α,CRP)before and after treatment were also compared.Results The normal time of body temperature recovery,time of getting out of bed and hospital stay in the observation group were significantly shorter than those in the control group(P<0.05).There was no statistical difference between the two groups in the time required for pain relief(P>0.05).The clinical curative rate of the control group was 93.33%(27/30),higher than that of the observation group[76.67%,(23/30)](P<0.05);the incidence of complications in the observation group was 6.67%(2/30),which was lower than that in the control group[13.33%(4/30)](P<0.05).The white blood cell count and inflammatory factors in the two groups had no significant difference before treatment(P>0.05).After 1 week of treatment,the levels of white blood cell count,IL-6,TNF-αand CRP in the observation group were(8.07±0.82)×109/L,(27.66±4.85)ng/mL(1.48±0.33)mg/L and(60.54±12.87)mg/L,which were lower compared with the control group[(10.14±0.96)×109/L,(49.78±5.37)ng/mL,(2.21±0.41)mg/L and(91.32±13.16)mg/L](P<0.05).Conclusion Although there is a certain tendency to relapse,the use of antibiotics in patients with acute simple appendicitis can effectively improve the clinical indicators of patients,reduce the incidence of complications and reduce the inflammatory response of patients,and the effect is acceptable.