甲硝哒唑预防重症阑尾炎术后切口感染

本文以1984年急性重症阑尾炎107例为对照组,以1985年急性重症阑尾炎117例作为治疗组,观察术前口服甲硝哒唑和术中用甲硝哒唑溶液冲洗腹腔及切口,对预防急性阑尾炎术后感染的效果。治疗组切口感染率2.6％,对照组切口感染率为12.1％,在统计学上有非常显著的差异。结果表明使用甲硝哒唑可有效地降低阑尾切除术后切口感染率。     

甲硝哒唑预防重症阑尾炎术后切口感染

本文以1984年急性重症阑尾炎107例为对照组,以1985年急性重症阑尾炎117例为治疗组,观察术前口服甲硝哒唑和术中用甲硝哒唑溶液冲洗腹腔及切口,对预防急性阑尾炎术后感染的效果。治疗组术前1小时口服甲硝哒唑1.0g(小儿400mg)。切口均用1%甲硝哒唑溶液100ml 冲洗浸泡5min(对腹     

甲硝哒唑直肠栓剂预防胃肠道穿孔性腹膜炎术后的切口感染

<正> 为了预防胃肠道穿孔性腹膜炎术后的切口感染,我院自1983年12月起,术前单次应用甲硝哒唑直肠栓剂,取得了明显效果。我们并对自制的甲硝哒唑直肠栓剂进行血药浓度测定,证明达到有效治疗浓度。临床资料一、对象和方法自1954年     

甲硝哒唑防治阑尾切除术切口感染

自1983年1月开始作者对住院100例病人采用甲硝哒唑防治阑尾切除后常见的切口感染,效果显著。治疗方法:化脓性阑尾炎单用甲硝哒唑,术后每8小时0.2g, 连服5天;穿孔或坏疽性阑尾炎,术后每8小时用甲硝哒唑0.2～0.5g,庆大霉素8万u,应用时间长短视病情而定。治疗结果:100例中切口感染8例,     

甲硝哒唑,庆大霉素预防阑尾切除术后切口感染

甲硝哒唑、庆大霉素预防阑尾切除术后切口感染罗占祥叶子雄我院自１９９０年１月～１９９４年１月，在阑尾切除术后应用甲硝哒唑、庆大霉素预防切口感染４２３例，现报道如下。１临床资料本组４２３例，男２２１例，女２０２例，年龄在８～７１岁。住院时间：发病２４ｈ内...     

甲硝哒唑预防阑尾切除后切口感染和腹腔残余脓肿

甲硝哒唑(Metronidazole)又名灭滴灵,原用于治疗阴道滴虫病和阿米巴病,现知它是一种抗厌氧微生物药物。我院经2年10个月的临床使用,证明它对预防阑尾切除术切口感染和腹腔残余脓肿有显著疗效。特别是甲硝哒唑与庆大霉素、氯霉素合用效果更佳。它具有副作用少、应用方便、价格低廉的特点,是一种很有前途的消炎药物。现报告如下:     

甲硝哒唑防治阑尾手术切口感染的疗效观察

手术切口感染是急症阑尾切除术后最常见的近期并发症,一直是胃肠外科的辣手问题。近年来,国外文献陆续报告应用甲硝哒唑(metronidazole,灭滴灵)预防阑尾手术切口感染,取得了显著的效果。我科自1983年11月～1984年10月间,对138例施行急症阑尾切除术的病人,应用甲硝哒唑防治手术切口感染。现将结果报告如下: 一般资料一、甲硝哒唑组:男85例,女53例,共138例。年龄最小14岁,最大68岁。     

甲硝哒唑预防阑尾炎手术切口感染的新观点

切口感染是阑尾炎手术后常见并发症。已往阑尾炎手术切口感染率约20～30％。近年来对阑尾炎手术切口感染病原菌和甲硝哒唑效应认识有了新观点,改进预防阑尾炎手术切口感染措施,使切口感染率明显降低,文献报告感染率降至8％,甚至更低,笔者观察组病例切口感染率由20％降至4％。 1.阑尾炎手术切口感染原因的新观点阑尾炎手术切口感染中原因很多:病原菌污染创口;阑尾炎类型;机体抵抗力、免疫机能;医     

术前抗菌素对急性化脓性阑尾炎手术切口的影响

目的探讨术前应用抗菌素对预防急性化脓性阑尾切除术切口感染的效果。方法将接受急性化脓性阑尾切除术患者按术前是否应用抗菌素且排除其它干扰因素分两个组,观察和对照组,对比两组患者术后切口感染的发生率。结果术前应用抗菌素组切口感染率为6.83%,术前不用药组为15.63%,P<0.05;术后切口局部红肿热痛率,未应用抗菌素组均明显高于用药组。结论术前使用抗菌素能有效减少急性化脓性阑尾炎行阑尾切除术后切口感染率。     

Preoperative antibiotic to prevent incision infection of acute suppurative appendicitis

目的 探讨术前应用抗菌素对预防急性化脓性阑尾切除术切口感染的效果.方法 将接受急性化脓性阑尾切除术患者按术前是否应用抗菌素且排除其它干扰因素分两个组,观察和对照组,对比两组患者术后切口感染的发生率.结果 术前应用抗菌素组切口感染率为6.83%,术前不用药组为15.63%,P<0.05;术后切口局部红肿热痛率,未应用抗菌素组均明显高于用药组.结论 术前使用抗菌素能有效减少急性化脓性阑尾炎行阑尾切除术后切口感染率.     

Metronidazole v. cefoxitin in severe appendicitis--a trial to compare a single intraoperative dose of two antibiotics given intravenously

In severe appendicitis, the effect of a single intravenous dose of metronidazole (500 mg) was compared with cefoxitin (1 g). The antibiotics were given by random allocation once the diagnosis had been established at operation. In the metronidazole group, 5 out of 48 patients developed a wound infection whilst in hospital compared with 13 out of 48 in the cefoxitin group (P = 0.036). However, 57% of wound infections became apparent after the patient went home and the overall infection rates were similar. The mean length of postoperative hospital stay was 5.0 days in the metronidazole group and 6.8 days in the cefoxitin group (P = 0.052), but of those who did develop a wound infection, the length of stay was almost double in the cefoxitin group. Anaerobic organisms were cultured from the wound in 7 out of 15 patients who received cefoxitin but in none of 5 patients in the metronidazole group. Whilst metronidazole only delayed the discharge of pus from the wound, it did seem to reduce the severity of infection. Cefoxitin appeared to be less effective, given as a single intravenous injection at a dose of 1 g.     

Antibiotics and postoperative abscesses in complicated appendicitis: is there any association?

INTRODUCTION: Complicated appendicitis has significant infective postoperative morbidity. There is no universally-accepted antibiotic regime, although traditionally, triple antibiotics are recommended. Our complicated appendicitis clinical pathway recommends ceftriaxone and metronidazole. The study aimed to determine if choice of antibiotics influenced the risk of infective complications. METHODS: We reviewed all paediatric appendicectomy patients between January 1, 2005 and December 31, 2005. All patients with intraoperative diagnosis of perforated appendicitis were recruited, excluding infants, immunocompromised patients, and patients allergic to the guideline antibiotics. All operations were performed by registrar/consultant surgeons and were laparoscopic, unless technically not feasible. RESULTS: There were 82 patients with perforated appendicitis. 62 patients (76 percent) followed pathway antibiotics, and 20 patients (24 percent) deviated from the pathway by receiving additional empiric gentamycin. We compared the pathway compliant and deviation groups, and found no significant differences in patient characteristics, clinical presentation, operation, length of stay and infective complications. Overall there was one wound infection and five (six percent) postoperative abscesses. Initial peritoneal cultures and subsequent drainage cultures of patients who developed abscesses were sensitive to treatment antibiotics. CONCLUSION: In complicated appendicitis, empirical perioperative addition of gentamycin to ceftriaxone and metronidazole did not reduce the risk of developing intra-abdominal abscess, compared to changing antibiotics on clinical grounds. Patients developed postoperative abscesses despite initial peritoneal cultures growing organisms sensitive to treatment antibiotics.     

Prophylactic Antibiotic during Caesarean Sections at Komfo Anokye Teaching Hospital, Kumasi

Summary OBJECTIVES: To compare the efficacy of co-amoxiclav (amoxicillin + clavulanic acid) and the triple therapy of ampicillin + gentamycin + metronidazole as prophylactic antibiotic during Caesarean sections. DESIGN: A randomized controlled trial. SETTING: The study was conducted between March and December 2002 at Komfo Anokye Teaching Hospital, Kumasi. PARTICIPANTS: Patients undergoing caesarean section were recruited into the study and given either drug as prophylaxis. Excluded were patients who had established infections prior to the operation, had had any antibiotic in the preceding 24 hours and those allergic to any of the trial drugs. INTERVENTIONS: A total of 320 patients were recruited and randomized on a one-to-one basis into two groups, 160 receiving co-amoxiclav whilst the other 160 received the triple therapy. In either case the drug was given as a single intravenous dose after cord clamping and repeated 12 hours later. No other antibiotic was given except in cases where frank infection was apparent post-operatively. OUTCOME MEASURES: Included abdominal wound infection, cough, dysuria, fever, uterine tenderness and offensive lochia after surgery. RESULTS: Abdominal wound infection was found in rates lower than in a previous study: 3.7% in the co-amoxiclav group and 13.1% in the triple therapy group as against 15.1% in the previous study. Co-amoxiclav was statistically found superior to the Triple Therapy in preventing abdominal wound infection and uterine tenderness. There was however, no statistical difference between the two groups as far as the prevention of cough, dysuria and fever were concerned. CONCLUSION: Co-amoxiclav was found to be a better prophylactic antibiotic.     

口腔颌面部狗咬伤患者一期缝合与延期缝合的疗效比较

目的：比较口腔颌面部狗咬伤患者行一期缝合与延期缝合治疗的效果,探讨一期缝合的可行性。方法：收集31例颌面部狗咬伤患者的临床资料,按照缝合方式分为一期缝合组（20例）和延期缝合组（11例）。一期缝合组患者伤口周围常规肥皂水冲洗,消毒皮肤,局部浸润麻醉,彻底清创,庆大霉素与甲硝唑交替冲洗,转移皮瓣,缝合伤口,术后应用抗生素并及时接种狂犬疫苗和破伤风疫苗。延期缝合组患者伤口周围常规肥皂水冲洗,消毒皮肤,局部浸润麻醉,彻底清创,庆大霉素与甲硝唑交替冲洗,无菌纱布覆盖创面,定期更换敷料,伤口延期缝合,术后常规注射狂犬疫苗和破伤风疫苗,全身应用抗生素。比较2组患者伤口感染率和温哥华瘢痕评定量表（VSS）评分。结果：一期缝合组20例患者中,有2例（10.00%）出现不同程度的伤口感染,无全身性感染出现,均未发生狂犬病及破伤风;延期缝合组11例患者中,有2例（9.09%）出现不同程度的伤口感染,无全身性感染出现,均未发生狂犬病及破伤风。2组患者伤口感染率比较差异无统计学意义（P>0.05）。一期缝合组患者VSS评分（Z=257）高于延期缝合组（Z=239）,组间比较差异有统计学意义（P<0.05）。结论：一期缝合患者伤口感染率与延期缝合相近,但一期缝合的伤口比延期缝合更美观,适用于口腔颌面部狗咬伤患者。     

甲硝唑对剖宫产切口感染患者血清白介素及其他炎性指标的影响

目的：研究甲硝唑对剖宫产切口感染患者血清白介素及其他炎性指标的影响。方法：124例剖宫产后切口感染患者随机分成两组,对照组和观察组各62例,对照组采用头孢类抗生素治疗,观察组在此基础上加甲硝唑。比较两组疗效及治疗前后血清白介素2、4、6、10（IL-2、IL-4、IL-6、IL-10）水平和其他炎症因子高敏C-反应蛋白（hs-CRP）、肿瘤坏死因子-a（TNF-α）、γ-干扰素（INF-γ）,一氧化氮（NO）水平的差异。结果：观察组患者抗生素用药天数及住院时间显著短于对照组,治疗3d后体温及血浆白细胞水平低于对照组,差异有统计学意义（P〈0.05）。治疗3、7d后观察组血清IL-2、IL-4、IL-6、IL-10水平和血清hs-CRP、TNF-α、INF-γ、NO水平均低于对照组,差异均有统计学意义（P均〈0.05）。结论：甲硝唑能有效促进剖宫产切口感染患者恢复,降低血清白介素及其他炎性指标水平。     

Intravenous gammaglobulin treatment in patients with hypogammaglobulinaemia

Intravenous gammaglobulin was compared with the standard British intramuscular preparation in patients with hypogammaglobulinaemia and chronic bronchitis. Five patients were given six months' treatment with the weekly intramuscular preparation and six months' treatment with intravenous gammaglobulin given once every 18 days. During the trial they recorded symptoms of infection, absence from work, and sputum volume; lung function tests were performed during the intravenous treatment. The half life of the intravenous IgG and changes in serum IgG and C1q concentrations were also measured in seven other patients who received intravenous gammaglobulin every two weeks for 12 weeks. IgG concentrations, sputum volume, and infection scores were significantly better during intravenous treatment and there were no adverse effects from the intravenous gammaglobulin. These five patients were significantly more healthy when they received an intravenous gammaglobulin preparation, probably because the intravenous preparation increased serum IgG concentrations. Although longer studies are needed, intravenous gammaglobulin should be considered for patients with severe chest disease and those who cannot tolerate intramuscular injections.     

产后甲硝唑擦洗预防会阴切口感染的临床观察

目的 :探讨产后应用甲硝唑擦洗预防会阴切口感染的作用。方法 :将同时期经阴道分娩行会阴侧切术的产妇随机分成两组 ,产后分别应用生理盐水和甲硝唑注射液每日擦洗外阴及会阴两次 ,比较两组切口愈合情况。结果 :观察组甲级愈合率为 99 12 % ,对照组 95 65 % ,观察组高于对照组。观察组乙级愈合率和丙级愈合率均低于对照组 ,差异有显著性 (P <0 0 1)。结论 :产后应用甲硝唑注射液擦洗会阴及切口 ,可有效预防伤口感染 ,有利于伤口愈合。     

肾康注射液联合厄贝沙坦对糖尿病肾病微量白蛋白的影响

目的：观察肾康注射液联合厄贝沙坦对早期糖尿病肾病患者24h尿微量白蛋白排泄率（Urinary Albumin Excretion Rate UAER）、血脂及血液流变性的影响。方法：将150例血压正常的早期糖尿病肾病患者随机分为对照组、肾康注射液组、肾康注射液加厄贝沙坦联合组,比较三组患者治疗前后UAER、血脂及血液流变学指标的变化。结果：治疗9周后,肾康注射液组和联合组在降低患者24h尿微量白蛋白排泄率、降低血脂及改善患者血液流变性方面均好于治疗前（P〈0．01）,且明显优于对照组（P〈0．05）,对照组改善情况不明显;肾康注射液加厄贝沙坦联合组在降低患者UAER、血脂及改善血液流变性方面,明显优于单用肾康注射液组（P〈0．05）。结论：肾康注射液可减少早期糖尿病肾病患者UAER,降低血脂,改善患者血液流变性,对早期糖尿病肾病具有治疗作用,且与厄贝沙坦合用可能有协同作用。     

甲硝唑联合头孢类抗生素对剖宫产切口感染患者血 清白介素及其他炎性指标的影响

研究分析甲硝唑联合头孢类抗生素对剖宫产切口感染患者血清白介素及其他炎性指标的影响。 方法　自２０１２年６月—２０１３年９月我院收治剖宫产切口感染患者中随机选取８６例作为研究对象,按入院的先 后顺序分成对照组和观察组,每组各为４３例,对照组剖宫产切口感染患者仅用头孢类抗生素进行治疗,观察组 患者在对照组患者治疗的基础之上联合使用甲硝唑进行治疗。比较两组患者的血清白介素和及其他炎性指标 的差异。结果　治疗后５天时观察组患者血清白介素中的ＩＬ－２、ＩＬ－４、ＩＬ－６、ＩＬ－１０分别是（３３２±０２８）ｕｇ／ ｌ、（４１２±０７８）ｕｇ／ｌ、（８１２±１２６）ｕｇ／ｌ、（５１２±０５６）ｕｇ／ｌ,其他炎性指标ｈｓ－ＣＲＰ、ＴＮＦ－ａ、ＩＮＦ－ｒ、ＮＯ分别 （３２１±０３２）ｍｇ／ｌ、（９３３８±１０１２）ｕｇ／ｌ、（１４５６±１３２）ｕｇ／ｌ、（８１３６±１０６８）ｕｇ／ｌ,均低于对照组,且两组之 间存在显著性差异（Ｐ＞００５）。结论　甲硝唑联合头孢类抗生素用于治疗剖宫产切口感染患者疗效显著,具有 积极的临床应用价值。     

幽门螺杆菌感染与缺铁性贫血的相关性研究

目的观察IDA伴Hp阳性慢性胃炎患者抗Hp加铁剂治疗前后实验室检测指标的变化及疗效,探讨幽门螺杆菌(Hp)感染与缺铁性贫血(IDA)形成的相关性及其临床意义。方法将62例IDA伴Hp阳性慢性胃炎患者,分为四组(A、B、C、D组)。A组给予补铁及Hp根除治疗,B组仅Hp根除治疗,C组仅补铁治疗,D组中医药辨证治疗胃炎。检测治疗前后其血红蛋白浓度及血清铁、总铁结合力、铁蛋白水平,并对Hp、胃蛋白酶活性、胃酸进行检测。结果缺铁性贫血伴慢性胃炎患者幽门螺杆菌感染率较高,联合补铁及抗Hp治疗效果显著。结论幽门螺杆菌感染可造成或加重机体铁营养不良,在治疗IDA的过程中应注意清除Hp感染。