CAJ | 학술논문

目的：观察莫西沙星联合ERCP技术治疗结石相关的胆道感染的有效性及安全性。方法将2010年10月至2011年10月于我科诊治的160例结石相关的胆道感染患者，随机分成试验组80例和对照组80例，患者在接受治疗性ERCP解除梗阻的同时，试验组给予莫西沙星针剂治疗，400 mg静脉滴注，每日1次；对照组给予头孢哌酮钠舒巴坦钠治疗，1.5 g静脉滴注，每12 h 1次。观察患者体温恢复正常的天数、术后第4天血白细胞计数和中性粒细胞比例，并于术后第4天进行胆汁细菌培养。结果除外剔除病例，试验组（72例）和对照组（73例）分别有8例和6例无效外，均治愈，治愈率分别为88.89%和91.78%，组间无显著差异（P＞0.05）。两组的体温恢复正常天数和术后第4天白细胞计数、中性粒细胞比例无显著差异（P＞0.05）。术后第4天试验组和对照组胆汁细菌清除率分别为84.70%（61/72）和86.30%（63/73）。两组间细菌清除率无显著性差异（P＞0.05）。两组的不良反应发生率试验组和对照组分别为4.17%（3/72）和2.74%（2/73），不良反应程度均为轻度，且均评定为可能有关。结论莫西沙星联合ERCP治疗结石相关的胆道感染安全有效。
목적：관찰막서사성연합ERCP기술치료결석상관적담도감염적유효성급안전성。방법장2010년10월지2011년10월우아과진치적160례결석상관적담도감염환자，수궤분성시험조80례화대조조80례，환자재접수치료성ERCP해제경조적동시，시험조급여막서사성침제치료，400 mg정맥적주，매일1차；대조조급여두포고동납서파탄납치료，1.5 g정맥적주，매12 h 1차。관찰환자체온회복정상적천수、술후제4천혈백세포계수화중성립세포비례，병우술후제4천진행담즙세균배양。결과제외척제병례，시험조（72례）화대조조（73례）분별유8례화6례무효외，균치유，치유솔분별위88.89%화91.78%，조간무현저차이（P＞0.05）。량조적체온회복정상천수화술후제4천백세포계수、중성립세포비례무현저차이（P＞0.05）。술후제4천시험조화대조조담즙세균청제솔분별위84.70%（61/72）화86.30%（63/73）。량조간세균청제솔무현저성차이（P＞0.05）。량조적불량반응발생솔시험조화대조조분별위4.17%（3/72）화2.74%（2/73），불량반응정도균위경도，차균평정위가능유관。결론막서사성연합ERCP치료결석상관적담도감염안전유효。
Objective To evaluate the clinical efficacy and security of maxifloxacin in combination with ERCP in the treatment of biliary infection related to calculus. Methods From October 2010 to October 2011, 160 patients with biliary infection related to calculus were randomly divided into treatment group (80 cases) and control group (80 cases). All the patients were treated by therapeutic ERCP to remove biliary obstruction, simultaneously. Treatment group was injected with maxifloxacin (400 mg,Qd) while control group with sulbactam and cefopcrazone (1.5 g, Q12 h). After treatment, observing the time that body temperature returned to normal. Fourth days after ERCP, blood WBC and neutrophil granulocyte ratio were recorded and bile bacteria were cultured. Results Excluding rejected cases, there was no significant difference between 2 groups in recovery rate that of treatment group was 88.89%(64/72)while control group was 91.78%(67/73)(P>0.05). The time of body temperature returning to normal, the leukocyte count and neutrophil granulocyte ratio had no significant difference between 2 groups (P>0.05). The bacterial in bile clearance rate of treatment group was 84.70%(61/72) while control group was 86.30%(63/73)on the 4th day after the therapy. The bacterial clearance rates showed no significant difference between 2 groups (P>0.05). The incidences of adverse effects were 4.17% and 2.74%respectively, which were slight and possibly related. Conclusion The therapy of maxifloxacin in combination with ERCP is effective and safe in treating biliary infection related to calculus.