CAJ | 학술논문

目的比较抗生素头孢西丁钠使用时间对肾移植围术期感染的影响.方法选择2013年3-12月于首都医科大学附属北京朝阳医院接受首次尸体肾移植患者40例,将患者完全随机分为2组(各20例),1周组给予头孢西丁钠2g/次,2次/d,共7d,2周组给予头孢西丁钠2g/次,2次/d,共14 d,2组患者均术前0.5～2.0 h静脉滴注头孢西丁钠2 g.比较2组患者一般资料、细菌感染情况和不良反应发生情况.结果 2组患者年龄、性别、透析类型、原发病、中心静脉导管保留时间、导尿管保留时间比较,差异均无统计学意义(均P ＞0.05),1周组住院时间、住院费用明显低于2周组[(17±5)d比(22 ±8)d、(61 253±13 651)元比(70 382±11 527)元],差异有统计学意义(P＜0.05).1周组发生感染3例(15.0％),均为尿路感染;2周组发生感染4例(20.0％),其中尿路感染2例,切口感染1例,肺部感染1例.2组移植后感染发生率差异无统计学意义(P＞0.05).2组均无过敏反应发生,有3例患者出现腹泻,2例患者白细胞降低,调整药物剂量后症状消失.结论肾移植患者围术期抗生素使用时间缩短,并不增加感染发生率,且可以缩短住院时间,降低住院费用.
목적 비교항생소두포서정납사용시간대신이식위술기감염적영향.방법 선택2013년3-12월우수도의과대학부속북경조양의원접수수차시체신이식환자40례,장환자완전수궤분위2조(각20례),1주조급여두포서정납2g/차,2차/d,공7d,2주조급여두포서정납2g/차,2차/d,공14 d,2조환자균술전0.5～2.0 h정맥적주두포서정납2 g.비교2조환자일반자료、세균감염정황화불량반응발생정황.결과 2조환자년령、성별、투석류형、원발병、중심정맥도관보류시간、도뇨관보류시간비교,차이균무통계학의의(균P ＞0.05),1주조주원시간、주원비용명현저우2주조[(17±5)d비(22 ±8)d、(61 253±13 651)원비(70 382±11 527)원],차이유통계학의의(P＜0.05).1주조발생감염3례(15.0％),균위뇨로감염;2주조발생감염4례(20.0％),기중뇨로감염2례,절구감염1례,폐부감염1례.2조이식후감염발생솔차이무통계학의의(P＞0.05).2조균무과민반응발생,유3례환자출현복사,2례환자백세포강저,조정약물제량후증상소실.결론 신이식환자위술기항생소사용시간축단,병불증가감염발생솔,차가이축단주원시간,강저주원비용.
Objective To explore the effect of duration of sodium cefoxitin on perioperative infection in renal transplant.Methods Totally 40 patients undergoing renal allograft transplantation from March to December 2013 were randomly divided into 1-week group treated with sodium cefoxitin (2 g/time, 2 times/d) for 7 days and 2-week group treated with sodium cefoxitin (2 g/time, 2 times/d) for 14 days.All recipients were administrated with sodium cefoxitin (2 g) intravenously 0.5-2.0 h before surgery.The general clinical data, incidences of infection and adverse events were compared between groups.Results There were no statistical differences in age, sex, type of dialysis, primary disease, length of central venous catheter retention time and urinary catheter retention time between two groups (P ＞ 0.05).The hospitalization duration and hospitalization expenses in 1-week group were significantly shorter and lower than those in 2-week group [(17 ±5) d vs (22 ± 8) d, (61 253 ± 13 651) yuan vs (70 382 ± 11 527) yuan] (P ＜0.05).The incidence of infection in 1-week group was 15.0％ (3/20), all being urinary tract infection;the incidence of infection in 2-week group was 20.0％ (1/20), being urinary tract infection in 2 cases, wound infection in 1 case and lung infection in 1 ease;no significantly difference was found between groups (P ＞ 0.05).No allergic reactions occurred in both groups;diarrhea occurred in 3 cases and leukopenia occurred in 2 cases, being disappeared after changing medicines.Conclusions Reducing utility duration of antibiotics after kidney transplantation does not increase the incidence of infection, and can shorten the hospitalization duration and reduce the costs.