| 卢仁福,谭远康,陈俊健,朱 昊,孙 茂.不同剂量头孢噻肟钠预防肺癌患者术后感染的疗效分析[J].,2018,(14):2678-2682 |
| 不同剂量头孢噻肟钠预防肺癌患者术后感染的疗效分析 |
| Effect Analysis of Different Doses of Cefotaxime Sodium on the Prevention of Postoperative Infection in Lung Cancer Patients |
| 投稿时间：2017-11-15 修订日期：2017-12-10 |
| DOI：10.13241/j.cnki.pmb.2018.14.016 |
| 中文关键词: 非小细胞肺癌 头孢噻肟钠 手术 感染 剂量 |
| 英文关键词: Non-small cell lung cancer Cefotaxime Sodium Surgery Infection Dose |
| 基金项目:重庆市自然科学基金重点资助项目（CSTC2012jjB10021） |
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| 中文摘要: |
| 摘要 目的：探讨不同剂量头孢噻肟钠对预防肺癌患者术后感染的临床疗效，为临床合理用药提供参考。方法：回顾性分析2013年1月-2015年8月在本院行肺癌根治术的90例非小细胞肺癌患者的临床资料，按照头孢噻肟钠使用剂量的不同分为小剂量组（n=44）和大剂量组（n=46）。两组患者术前30 min均给予头孢噻肟钠静滴，其中小剂量组给予2g注射用头孢噻肟钠+0.9% NaCl 100 mL，当手术时间超过3 h，术中再次给予同等剂量头孢噻肟钠静滴，术后12 h给予2 g头孢噻肟钠静滴，大剂量组用药方法同小剂量组，各阶段头孢噻肟钠用量改为3 g。观察并比较两组患者术前、术后3 d血清超敏C反应蛋白（hs-CRP）、肿瘤坏死因子-α（TNF-α）、白蛋白（ALB）、白细胞计数（WBC）的变化情况，记录患者住院时间、切口愈合时间、术后感染及不良反应发生情况，统计两组病原菌清除率。结果：术后3 d两组患者血清hs-CRP、TNF-α、WBC水平均较术前上升，血清ALB水平较术前下降，有统计学差异（P<0.05），但两组间上述指标比较差异无统计学意义（P>0.05）。小剂量组患者住院时间为（18.80±2.50）d、手术切口愈合时间为（13.50±1.05）d，大剂量组分别为（18.10±2.35）d、（12.95±2.05）d，两组比较差异无统计学意义（P>0.05）。小剂量组与大剂量组术后感染率为9.09%、10.87%，病原菌清除率为83.33%、85.71%，两组患者感染率、病原菌清除率比较差异均无统计学意义（P>0.05），且用药期间均未发生严重不良反应。结论：对围手术期肺癌患者给予小剂量头孢噻肟钠能达到与大剂量用药相同的预防术后感染效果，且安全有效，值得推广使用。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the effect of different doses of Cefotaxime Sodium on the prevention of postoperative infection in lung cancer patients, so as to provide the basis for clinical rational use of drugs. Methods: The clinical data of 90 patients with non-small cell lung cancer underwent radical resection in our hospital from January 2013 to August 2015 were analyzed retrospectively. The patients were divided into low-dose group (n=44) and high-dose group (n=46) according to the using doses of Cefotaxime Sodium. The intravenous injection of Cefotaxime Sodium were given for both two groups, in which the low-dose group was injected with 2g Ce- fotaxime Sodium+0.9% NaCl 100 mL, when the surgery time was more than three hours, the patients were continuously given the same dose of Cefotaxime Sodium by intravenous injection during the surgery, finally the patients were given 2 g Cefotaxime Sodium by intra- venous injection twelve hours after the surgery. The drug application methods of high-dose group was the same as the low-dose group, except change the usage to 3 g in each period of surgery. The changes of serum high sensitivity C reactive protein (hs-CRP), tumor necro- sis factor-α (TNF-α), albumin (ALB), white blood cell count (WBC) were observed and compared in two groups before surgery and three days after surgery. The length of stay and surgical incision healing time, incidence rate of postoperative infection and adverse reactions in two groups were recorded, and the clearance rate of pathogenic bacteria in two groups were counted. Results: Three days after surgery, the serum hs-CRP, TNF-α and WBC in two groups were higher than before surgery, and the serum ALB was lower than before surgery (P<0.05), but the differences of above indexes in two groups after surgery had no statistical significance (P>0.05). The length of stay and surgical incision healing time in low-dose group were (18.80±2.50) days and (13.50±1.05) days respectively, which in high-dose group was (18.10±2.35) days and(12.95±2.05) days, there was no significant difference between the two groups (P>0.05). The incidence rate of postoperative infection between the two groups were 9.09%, 10.87%, and pathogenic bacteria clearance rate were 83.33%, 85.71%, there was no significant difference in infection rate and pathogenic bacteria clearance rate between the two groups (P>0.05), and there was no obvious adverse reactions during treatment in two groups. Conclusion: Giving low-dose of Cefotaxime Sodium can achieve the same effect of preventing postoperative infection in lung cancer patients as the high-dose of Cefotaxime Sodium, which with good safety and efficacy, and it is worthy to promotion and application. |
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