预防性使用抗菌药物在腹腔镜子宫肌瘤剔除术患者中的应用效果

Application effects of prophylactic use of antibiotics in patients undergoing laparoscopic myomectomy

目的:观察预防性使用抗菌药物在腹腔镜子宫肌瘤剔除术患者中的应用效果。方法:回顾性分析2021年5月至2022年4月该院收治的112例腹腔镜子宫肌瘤剔除术患者的临床资料,按照抗菌药物使用方法不同将其分为研究组和对照组各56例。研究组预防性使用抗菌药物,对照组常规使用抗菌药物,抗菌药物均为苯唑西林钠。比较两组手术相关指标(住院时间、手术时间、术中出血量、首次排气时间)水平,手术前后血清学指标[肿瘤坏死因子-α(TNF-α)、γ干扰素(IFN-γ)、白细胞介素(IL)-1β、IL-8、C反应蛋白(CRP)]水平、疼痛介质[5-羟色胺(5-HT)、神经肽Y(NPY)、前列腺素E2(PGE2)]水平,以及切口感染发生率。结果:两组手术时间、术中出血量比较,差异均无统计学意义(P>0.05);研究组住院时间、首次排气时间均短于对照组,差异有统计学意义(P<0.05);术后3 d,两组IFN-γ、IL-1β、CRP、IL-8、TNF-α、PGE2、NPY、5-HT水平均高于术前,但研究组低于对照组,差异有统计学意义(P<0.05);术后随访1周,研究组切口感染发生率为1.79%(1/56),低于对照组的16.07%(9/56),差异有统计学意义(P<0.05)。结论:腹腔镜子宫肌瘤剔除术患者预防性使用抗菌药物可缩短住院时间和首次排气时间,降低切口感染发生率、疼痛介质水平和血清学指标水平,效果优于常规使用抗菌药物。

Objective:To observe application effects of prophylactic use of antibiotics in patients undergoing laparoscopic myomectomy.Methods:The clinical data of 112 patients with laparoscopic myomectomy admitted to this hospital from May 2021 to April 2022 were retrospectively analyzed.According to the different methods of using antibiotics,they were divided into study group and control group,56 cases in each group.The study group was given prophylactic use of antibiotics,while the control group was given routine use of antibiotics.All antibiotics were Piperacillin sodium.The levels of operation-related indexes(hospitalization time,operation time,intraoperative blood loss,first exhaust time),the serological indexes[tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),interleukin(IL)-1β,IL-8,C-reactive protein(CRP)],and the pain mediators[5-hydroxytryptamine(5-HT),neuropeptide Y(NPY),prostaglandin E2(PGE2)]before and after the surgery,and the incidence of incision infection were compared between the two groups.Results:There were no significant differences in the operation time and the intraoperative blood loss between the two groups(P>0.05).The hospitalization time and the first exhaust time of the study group were shorter than those of the control group,and the differences were statistically significant(P<0.05).3 days after the surgery,the levels of IFN-γ,IL-1β,CRP,IL-8,TNF-α,PGE2,NPY and 5-HT in the two groups were higher than those before the surgery,but those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).After 1 week of follow-up,the incidence of incision infection in the study group was 1.79%(1/56),which was lower than 16.07%(9/56)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Prophylactic use of antibiotics in the patients undergoing laparoscopic myomectomy can shorten the hospitalization time and the first exhaust time,reduce the incidence of incision infection and the levels of pain mediators,and the levels of serological indexes.Moreover,it is superior to routine use of antibiotics.