论文部分内容阅读
目的探讨肝癌射频消融术围术期预防性应用抗菌药物的必要性,为管理部门下一步制定政策提供依据。方法根据围术期抗菌药物使用情况,采用纵断面分析方法并按照入选标准选取80例患者行90例次射频消融术,分为抗菌药物充分预防组、一般预防组、非预防组各30例次。充分预防组围术期予头孢美唑钠(1 g,iv gtt,bid);一般预防组围术期予头孢唑林(1 g,iv gtt,tid);非预防组围术期不使用抗菌药物。比较3组术后消融综合征及感染指标的发生情况。结果3组共80例次出现体温升高,其中充分预防组27例次,一般预防组28例次,非预防组25例次;25例次患者出现中性粒细胞升高,其中充分预防组8例次,一般预防组9例次,非预防组8例次;出现中性粒细胞+白细胞异常升高者共7例次,其中充分预防组2例次,一般预防组3例次,非预防组2例次。结合实验室检查及I临床症状,无一例诊断为败血症,经术后抗感染治疗后血常规恢复正常。3组术后主要消融综合征及感染指标的发生情况差异没有统计学意义。结论肝功能储备较好且不涉及高危病灶的肝癌患者行射频消融术围术期没有必要预防性使用抗菌药物。
Objective To investigate the necessity of perioperative prophylactic use of antimicrobial agents for radiofrequency ablation of liver cancer and provide the basis for the management to formulate policies in the next step. Methods According to the use of perioperative antibacterials, 90 patients undergoing radiofrequency catheter ablation were selected from 80 patients according to the criteria of longitudinal analysis. The patients were divided into three groups: full prevention group, general prevention group and non-prevention group . Cefmetazole sodium (1 g, iv gtt, bid) was given during the perioperative period in the full prevention group. Cefazolin (1 g, iv gtt, tid) was administered in the general prevention group during the perioperative period. Antibiotics drug. The incidence of postoperative ablation syndrome and infection index were compared between the three groups. Results A total of 80 cases occurred in 3 groups with body temperature increasing. There were 27 cases in full prevention group, 28 cases in general prevention group and 25 cases in non-prevention group. Neutrophils increased in 25 cases, 8 cases, general prevention group 9 cases, non-prevention group 8 cases; neutrophil + leukocyte abnormal increase in a total of 7 cases, of which 2 cases of adequate prevention group, general prevention group of 3 cases, Prevention group of 2 cases. Combined with laboratory tests and I clinical symptoms, no case of diagnosis of sepsis, after anti-infective treatment of blood returned to normal. No significant difference was found in the incidence of major ablation syndrome and infection after operation between the three groups. Conclusions Radiofrequency ablation of patients with hepatocellular carcinoma who have good liver function reserve and do not involve high-risk lesions is not necessary for prophylactic use of antimicrobial agents during perioperative period.