摘要
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。
AIM To investigate the necessity of prophylactic usage of antibacterial drugs during preoperative peri- od of radiofrequency ablation（ RFA） for liver cancer, and to provide evidence of formulating document for administrative department. METHODS To use longitudinal analysis approach 90 RFA in 80 patients were selected and divided into adequate prophylaxis group（30）, general prophylaxis group （30） and non-prophylaxis group （30） according to their an- tibacteria] drug application during preoperative period. Cefmetazole sodium（｜ g, iv gtt, bid）for adequate prophylaxis group and cefazolin（ 1 g, iv gtt, rid）for general prophylaxis group were dripped, any antibacterial drugs were not used for non- prophylaxis group. RFA syndrome and makers of infection were compared among them. RESULTS A total of 80 patients in 3 groups had a fever among which 27 were for adequate prophylaxis group, 28 were for general prophylaxis group and 25 were for non-prophylaxis group, respectively. And 25 patients appeared elevated neutrophilic granulocytes among which 8 were for adequate prophylaxis group, 9 were for general prophylaxis group and 8 were for non-prophylaxis group, re- spectively. A total of 7 patients in 3 groups appeared elevated neutrophilic granulocytes accompanying abnormally elevated leukocytes among which 2 were for adequate prophylaxis group, 3 were for general prophylaxis group and 2 were for non- prophylaxis group, respectively. Incorporating laboratory examination and clinical symptom no septicemia was diagnosed, their hemogram went back to normal after anti-infective therapy. There was no statistic significance in RFA syndrome and makers of infection among them. CONCLUSION There is no need to use prophylactic antibacterial drugs during peri-op-erative period for RFA of hepatic carcinoma patients with good hepatic reservoir and free from high risk lesions.
出处
《中国临床药学杂志》
CAS
2013年第4期238-241,共4页
Chinese Journal of Clinical Pharmacy
基金
中国药学会科技开发中心委托研究项目(编号2012DCST010T77)
关键词
射频消融
围术期
抗菌药物
肝癌
预防性应用
必要性
radiofrequency ablation
peri-operative period
antibacterial drug
hepatic carcinoma
phylactic usage
necessity
