甲硝唑与头孢呋辛钠围术期联合应用对急性阑尾炎手术患者术后切口感染及炎性因子水平的影响

Effects of Combined Application of Metronidazole and Cefuroxime Sodium during Perioperative Period on Postoperative Incision Infection and Inflammatory Factor Levels in Patients with Acute Appendicitis

目的观察甲硝唑与头孢呋辛钠围术期联合应用对急性阑尾炎手术患者术后切口感染及炎性因子水平的影响.方法将86例急性阑尾炎患者按随机数字表法分为对照组和观察组,每组43例.对照组围术期给予头孢呋辛钠治疗,观察组围术期给予甲硝唑联合头孢呋辛钠治疗.比较2组术前、术后3 d炎症因子[包括肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-8(IL-8)]水平,观察2组术后感染与不良反应发生情况.结果2组术前血清TNF-α、CRP、IL-8水平比较差异无统计学意义(P>0.05);2组术后3 d血清TNF-α、CRP、IL-8水平均较术前显著降低,且观察组降低较对照组更为显著,差异有统计学意义(P<0.001).观察组术后感染发生率为4.65%,对照组为18.60%,观察组术后感染发生率显著低于对照组(χ^(2)=4.084、P=0.044);2组不良反应发生率比较差异无统计学意义(P>0.05).结论甲硝唑与头孢呋辛钠围术期联合应用可降低急性阑尾炎患者术后机体炎症因子水平及切口感染风险,且联合应用未增加不良反应风险,安全性较高.

Objective To observe the effects of combined application of metronidazole and cefuroxime sodium during perioperative period on postoperative incision infection and inflammatory factor levels in patients with acute appendicitis.Methods A total of 86 patients with acute appendicitis were randomly treated with cefuroxime sodium alone(control group,n=43)or in combination with metronidazole(observation group,n=43)during the perioperative period.The levels of tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and interleukin-8(IL-8)were measured before and 3 days after operation.In addition,postoperative infection and adverse reactions were compared between the two groups.Results There were no significant differences in serum TNF-α,CRP and IL-8 levels between the two groups before operation(P>0.05).Compared with preoperative levels,serum TNF-α,CRP and IL-8 decreased at 3 days after operation,and the decrease in the observation group was more obvious than that in the control group(P<0.001).The incidence of postoperative infection in the observation group(4.65%)was lower than that in the control group(18.60%)(χ^(2)=4.084,P=0.044).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The combined use of metronidazole and cefuroxime sodium during perioperative period can safely reduce the levels of inflammatory factors and the risk of incision infection,and does not increase the risk of adverse reactions in patients with acute appendicitis.